Cazzolla Angela Pia, Brescia Vincenzo, Lovero Roberto, Cardinali Roberta, Di Serio Francesca, Lorusso Mauro, Ciavarella Domenico, Testa Nunzio Francesco, Dipalma Gianna, Di Cosola Michele, Lo Muzio Lorenzo, Crincoli Vito, Di Comite Mariasevera
Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy.
Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy.
J Clin Med. 2025 May 26;14(11):3712. doi: 10.3390/jcm14113712.
The aim of this observational study was to evaluate whether the presence of periapical inflammatory cysts (PIC) is accompanied by a state of vitamin D (25OHD) 25(OH)D insufficiency or deficiency and biochemical variations in biomarkers of bone metabolism such as osteocalcin (OC), isoenzyme of bone alkaline phosphatase (BALP), and C-terminal telopeptide of type 1 collagen (CTX). A total of 56 patients (group P), 36 males and 20 females, of which 42 had one cyst (group P1) and 14 had multiple periapical cysts (group P2), alongside 56 healthy subjects (group H) were recruited. Rx-OPT and clinical evaluation were used to evaluate the presence of PIC. At the first visit, all subjects underwent venous sampling (group P and H) to measure bone biomarkers by the chemiluminescence method. The Mann-Whitney test was used to compare the different biomarkers in the H vs. P, H vs. P1, H vs. P2, and P1 vs. P2 groups. The Mann-Whitney test was used to compare biomarker levels between the study groups. ROC curves were used to search for the concentration of the different biomarkers in which the best sensitivity and specificity were found. 25OHD and CTX showed a difference between H vs. P, H vs. P1, H vs. P2, and P1 vs. P1 groups ( < 0.05). The study of the ROC curves with a comparison between concentrations in the H vs. P group showed the best sensitivity and specificity for 25OHD at a concentration <19 ng/mL, highlighting a picture of 25OHD deficiency. The presence of apical cysts could be indicative of a vitamin D deficiency that should be appropriately treated. The findings suggest that vitamin D deficiency, given its role in bone metabolism and mineralisation, may contribute to a biological environment that favours the development or persistence of periapical cystic lesions.
本观察性研究的目的是评估根尖周炎性囊肿（PIC）的存在是否伴有维生素D（25OHD）不足或缺乏状态，以及骨代谢生物标志物如骨钙素（OC）、骨碱性磷酸酶同工酶（BALP）和I型胶原C末端肽（CTX）的生化变化。共招募了56例患者（P组），其中男性36例，女性20例，其中42例有一个囊肿（P1组），14例有多个根尖周囊肿（P2组），以及56例健康受试者（H组）。采用口腔X线根尖片（Rx-OPT）和临床评估来评估PIC的存在。在首次就诊时，所有受试者（P组和H组）均接受静脉采血，通过化学发光法测量骨生物标志物。采用曼-惠特尼检验比较H组与P组、H组与P1组、H组与P2组以及P1组与P2组之间的不同生物标志物。采用曼-惠特尼检验比较各研究组之间的生物标志物水平。采用ROC曲线寻找不同生物标志物的浓度，以确定其具有最佳敏感性和特异性。25OHD和CTX在H组与P组、H组与P1组、H组与P2组以及P1组与P1组之间存在差异（P<0.05）。对H组与P组浓度进行比较的ROC曲线研究显示，25OHD浓度<19 ng/mL时具有最佳敏感性和特异性，突出显示了25OHD缺乏的情况。根尖囊肿的存在可能表明维生素D缺乏，应予以适当治疗。研究结果表明，鉴于维生素D在骨代谢和矿化中的作用，其缺乏可能促成了有利于根尖周囊性病变发生或持续存在的生物学环境。
