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唾液血红蛋白、乳酸脱氢酶和白细胞介素-6对2型糖尿病患者慢性牙周炎和牙齿缺失的诊断准确性

Diagnostic accuracy of salivary hemoglobin, lactate dehydrogenase and Interleukin-6 to determine chronic periodontitis and tooth loss in type 2 diabetics.

作者信息

Sangappa Sunila Bukanakere, Mysore Babu Harsha, C Savadi Ravindra, Jithendra Ashwini

机构信息

Department of Prosthodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570015, India.

Department of Periodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India.

出版信息

J Oral Biol Craniofac Res. 2024 Sep-Oct;14(5):606-613. doi: 10.1016/j.jobcr.2024.08.002. Epub 2024 Aug 13.

Abstract

BACKGROUND

Salivary Hemoglobin (SH) has emerged as the mainstay non-invasive and a practicable screening method for Chronic Periodontitis. Current research aims to comprehensively assess the diagnostic value of Salivary Hb (SH) in comparison with Salivary IL-6 (SIL-6) and levels of Salivary lactate dehydrogenase enzyme (SLDH) amongst Type II Diabetes subjects having Chronic Periodontitis (CP) and associated tooth loss.

MATERIALS AND METHODS

In this cross-sectional comparative investigation, 240 individuals with at least 15 remaining teeth, ranging in age from 30 to 70, were chosen and Group I controls were defined as follows: healthy (HbA1c levels ≤6.4 %) with no CP; Group II included chronic periodontitis and non-T2DM (HbA1c ≤ 6.4 %); Group III included T2DM (HbA1c ≥ 6.5 %) and CP; and Group IV included T2DM (HbA1c ≥ 6.5 %) with periodontitis-related tooth loss. ELISA colorimetric assay was used to quantify the results using the unstimulated whole saliva of fasting participants. Tukey's post hoc test was used for statistical analysis following Analysis of Variance (ANOVA), and Sensitivity and Specificity were computed following the determination of the correlation coefficient.

RESULTS

One-way ANOVA comparing Biomarker levels across the four groups revealed a statistically significant difference (F = 68.013) (p = 0.0001). Tukey's multiple post hoc yielded a significant difference between groups with least mean average biomarker levels observed among the controls (Group1) and maximum with group IV. Diagnostic Accuracy to discriminate between CP in T2DM & Controls with SH surpassed that of SIL-6 & SLDH, Receiver operating characteristic (ROC) curve depicted an overall sensitivity of 67.62 %, specificity of 80 % and accuracy of 74 % in T2DM subjects with tooth loss for the identification and assessment of CP.

CONCLUSION

Estimates of Salivary Hemoglobin can assume an important role in comparison to SIL-6 & SLDH in determining the degree of periodontitis, including tooth loss, and identifying elevated glycemic levels. Advanced detection and monitoring can be ensured by routine use in dental offices and general practice.

摘要

背景

唾液血红蛋白(SH)已成为慢性牙周炎的主要非侵入性实用筛查方法。当前研究旨在全面评估唾液血红蛋白(SH)与唾液白细胞介素-6(SIL-6)以及唾液乳酸脱氢酶(SLDH)水平相比,在患有慢性牙周炎(CP)及相关牙齿缺失的II型糖尿病患者中的诊断价值。

材料与方法

在这项横断面比较研究中,选取了240名年龄在30至70岁之间、至少保留15颗牙齿的个体,I组对照组定义如下:健康(糖化血红蛋白水平≤6.4%)且无慢性牙周炎;II组包括慢性牙周炎且非2型糖尿病(糖化血红蛋白≤6.4%);III组包括2型糖尿病(糖化血红蛋白≥6.5%)且患有慢性牙周炎;IV组包括患有与牙周炎相关牙齿缺失的2型糖尿病(糖化血红蛋白≥6.5%)。采用ELISA比色法,使用空腹参与者的非刺激性全唾液对结果进行定量分析。方差分析(ANOVA)后采用Tukey事后检验进行统计分析,确定相关系数后计算敏感性和特异性。

结果

对四组生物标志物水平进行的单向方差分析显示存在统计学显著差异(F = 68.013)(p = 0.0001)。Tukey多重事后检验显示,对照组(I组)的平均生物标志物水平最低,IV组最高,两组之间存在显著差异。用SH区分2型糖尿病患者与对照组中的慢性牙周炎的诊断准确性超过了SIL-6和SLDH,受试者工作特征(ROC)曲线显示,在患有牙齿缺失的2型糖尿病患者中,用于识别和评估慢性牙周炎的总体敏感性为67.62%,特异性为80%,准确性为74%。

结论

与SIL-6和SLDH相比,唾液血红蛋白的检测在确定牙周炎程度(包括牙齿缺失)以及识别血糖水平升高方面可发挥重要作用。通过在牙科诊所和普通医疗实践中的常规使用,可以确保进行早期检测和监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f07/11379658/16156b1f70fa/gr1.jpg

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