Umeizudike Kehinde Adesola, Aji Nur Rahman Ahmad Seno, Niskanen Katariina, Rantala Iina, Sakellari Dimitra, Grigoriadis Andreas, Pätilä Tommi, Gupta Shipra, Sorsa Timo, Räisänen Ismo T
Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
Eur J Dent. 2025 May;19(2):305-314. doi: 10.1055/s-0044-1788797. Epub 2024 Oct 1.
The aim of this cross-sectional study was to investigate the relationship between periodontitis, potential periodontitis oral fluid biomarkers, and prediabetes.
This study included 150 Greek adults aged 25 to 78 years who were tested with an Hemoglobin A1C (HBA1c) diagnostic system, an active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test, and several salivary biomarkers enzyme-linked immunosorbent assay tests and gelatin zymography. A full-mouth clinical examination was performed to assess their periodontal and oral health status.
The Kruskal-Wallis test was used to determine the statistically significant difference in the levels of periodontal oral fluid biomarkers between the different periodontitis stages, periodontitis grades, and the stages and grades of periodontitis combined. Spearman's rank correlation was performed to assess the strength and direction of the association between aMMP-8 and HbA1c levels (<5.7 and ≥5.7%) and with the other oral fluid biomarkers among patients with severe periodontitis. A two-sided -value below 0.05 was considered statistically significant in this study.
aMMP-8, but not total MMP-8 or other biomarkers, associated significantly with the stage and grade of periodontitis combined ( < 0.001, Kruskal-Wallis test). Among stage III grade C periodontitis patients, aMMP-8 levels were significantly positively correlated with prediabetes (Spearman's rho = 0.646, = 0.044), total MMP-8 (rho = 0.636, = 0.048), PMN Elastase (rho = 0.729, = 0.017), total MMP-9 (rho = 0.721, = 0.019), and total MMP-8/TIMP-1 molar ratio (rho = 0.879, < 0.001).
Prediabetic disease development can upregulate MMP-8 expression (total MMP-8) in rapidly progressing, severe periodontitis, where MMP-8 latent species are further activated into their active forms (aMMP-8). Simultaneously, several proinflammatory biomarker levels are elevated in this tissue-destructive biomarker cascade. This development is easily detectable online/in real-time within 5 minutes by aMMP-8 PoC testing at the dentist's office.
本横断面研究旨在调查牙周炎、潜在的牙周炎口腔液生物标志物与糖尿病前期之间的关系。
本研究纳入了150名年龄在25至78岁之间的希腊成年人，他们接受了糖化血红蛋白（HbA1c）诊断系统、活性基质金属蛋白酶-8（aMMP-8）即时检测（PoC）以及几种唾液生物标志物的酶联免疫吸附测定和明胶酶谱检测。进行了全口临床检查以评估他们的牙周和口腔健康状况。
采用Kruskal-Wallis检验来确定不同牙周炎阶段、牙周炎分级以及牙周炎阶段和分级组合之间牙周口腔液生物标志物水平的统计学显著差异。进行Spearman等级相关性分析，以评估重度牙周炎患者中aMMP-8与HbA1c水平（<5.7%和≥5.7%）以及其他口腔液生物标志物之间关联的强度和方向。在本研究中，双侧P值低于0.05被认为具有统计学显著性。
aMMP-8与牙周炎的阶段和分级组合显著相关（P<0.001，Kruskal-Wallis检验），而总MMP-8或其他生物标志物则不然。在III C期牙周炎患者中，aMMP-8水平与糖尿病前期显著正相关（Spearman相关系数rho=0.646，P=0.044）、总MMP-8（rho=0.636，P=0.048）、中性粒细胞弹性蛋白酶（rho=0.729，P=0.017）、总MMP-9（rho=0.721，P=0.019）以及总MMP-8/TIMP-1摩尔比（rho=0.879，P<0.001）。
在快速进展的重度牙周炎中，糖尿病前期疾病的发展可上调MMP-8表达（总MMP-8），其中MMP-8潜在形式进一步激活为活性形式（aMMP-8）。同时，在这个组织破坏性生物标志物级联反应中，几种促炎生物标志物水平升高。通过在牙医诊所进行aMMP-8 PoC检测，可在5分钟内轻松实现对这种发展的在线/实时检测。
