Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
J Dent Res. 2024 Jan;103(1):13-21. doi: 10.1177/00220345231203562. Epub 2023 Nov 15.
Systemic metabolic signatures of oral diseases have been rarely investigated, and prospective studies do not exist. We analyzed whether signs of current or past infectious/inflammatory oral diseases are associated with circulating metabolites. Two study populations were included: the population-based Health-2000 ( = 6,229) and Parogene ( = 452), a cohort of patients with an indication to coronary angiography. Health-2000 participants ( = 4,116) provided follow-up serum samples 11 y after the baseline. Serum concentrations of 157 metabolites were determined with a nuclear magnetic resonance spectroscopy-based method. The associations between oral parameters and metabolite concentrations were analyzed using linear regression models adjusted for age, sex, number of teeth, smoking, presence of diabetes, and education (in Health-2000 only). The number of decayed teeth presented positive associations with low-density lipoprotein diameter and the concentrations of pyruvate and citrate. Negative associations were found between caries and the unsaturation degree of fatty acids (FA) and relative proportions of docosahexaenoic and omega-3 FAs. The number of root canal fillings was positively associated with very low-density lipoprotein parameters, such as diameter, cholesterol, triglycerides, and number of particles. Deepened periodontal pockets were positively associated with concentrations of cholesterol, triglycerides, pyruvate, leucine, valine, phenylalanine, and glycoprotein acetyls and negatively associated with high-density lipoprotein (HDL) diameter, FA unsaturation degree, and relative proportions of omega-6 and polyunsaturated FAs. Bleeding on probing (BOP) was associated with increased concentrations of triglycerides and glycoprotein acetyls, as well as decreased proportions of omega-3 and omega-6 FAs. Caries at baseline predicted alterations in apolipoprotein B-containing lipoproteins and HDL-related metabolites in the follow-up, and both caries and BOP were associated with changes in HDL-related metabolites and omega-3 FAs in the follow-up. Signs of current or past infectious/inflammatory oral diseases, especially periodontitis, were associated with metabolic profiles typical for inflammation. Oral diseases may represent a modifiable risk factor for systemic chronic inflammation and thus cardiometabolic disorders.
口腔疾病的系统性代谢特征很少被研究，也没有前瞻性研究。我们分析了当前或过去的感染/炎症性口腔疾病的迹象是否与循环代谢物有关。纳入了两个研究人群：基于人群的 Health-2000（=6229）和 Parogene（=452），后者是一群有冠状动脉造影适应证的患者。Health-2000 参与者（=4116）在基线后 11 年提供了随访血清样本。使用基于核磁共振光谱的方法测定了 157 种代谢物的血清浓度。使用线性回归模型分析了口腔参数与代谢物浓度之间的关系，模型调整了年龄、性别、牙齿数量、吸烟、糖尿病和教育（仅在 Health-2000 中）。龋齿的数量与低密度脂蛋白直径以及丙酮酸和柠檬酸的浓度呈正相关。龋齿与脂肪酸（FA）的不饱和度和二十二碳六烯酸和 omega-3 FA 的相对比例呈负相关。根管填充数量与极低密度脂蛋白参数呈正相关，如直径、胆固醇、甘油三酯和颗粒数。牙周袋加深与胆固醇、甘油三酯、丙酮酸、亮氨酸、缬氨酸、苯丙氨酸和糖蛋白乙酰的浓度呈正相关，与高密度脂蛋白（HDL）直径、FA 不饱和度和 omega-6 和多不饱和 FA 的相对比例呈负相关。探诊出血（BOP）与甘油三酯和糖蛋白乙酰浓度升高以及 omega-3 和 omega-6 FA 比例降低有关。基线时的龋齿预测了随访中载脂蛋白 B 含脂蛋白和 HDL 相关代谢物的改变，而龋齿和 BOP 都与随访中 HDL 相关代谢物和 omega-3 FA 的改变有关。当前或过去的感染/炎症性口腔疾病的迹象，特别是牙周炎，与炎症相关的代谢特征有关。口腔疾病可能是全身慢性炎症和心血管代谢疾病的可改变危险因素。
