牙周炎和高血压患者血清及唾液中的促炎标志物

Pro-Inflammatory Markers in Serum and Saliva in Periodontitis and Hypertension.

作者信息

Bolyarova Teodora, Stefanov Lyubomir, Naseva Emilia, Stamatov Konstantin, Dzhenkov Samuil, Stoimenov Blagovest, Pancheva Ralitsa, Dochev Nikolay, Ishkitiev Nikolay

机构信息

Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria.

Department of Health Management and Health Economics, Faculty of Public Health "Prof. Tzecomir Vodenitcharov, MD, DSc", Medical University of Sofia, 1524 Sofia, Bulgaria.

出版信息

Medicina (Kaunas). 2025 May 31;61(6):1024. doi: 10.3390/medicina61061024.

DOI:10.3390/medicina61061024

PMID:40572711

Abstract

: Over the past few decades, a substantial body of evidence has linked periodontitis to systemic diseases-including hypertension-but the mechanisms underlying this association are not fully understood. This study aims to identify the factors that may mediate this relationship, including an analysis of the inflammatory biomarker NLRP3 and IL-1β levels in serum and saliva in patients with both diseases. : This study included 108 individuals (mean age, 47.8 years, SD 12.8), 38.9% male and 61.1% female. The participants were divided into four groups: Group I-26 healthy participants; Group II-24 participants with periodontitis; Group III-26 participants with hypertension; and Group IV-32 participants with both periodontitis and hypertension. Clinical examinations were performed to diagnose hypertension and periodontitis, including a survey and blood tests in all patients. NLRP3 and IL-1β levels in serum and saliva were measured using ELISA. : Patients with periodontitis and hypertension were significantly older than those without these conditions (respectively, < 0.001 and < 0.001) and had more missing teeth (respectively, < 0.001 and = 0.037). Higher values were found in the periodontitis and hypertension group than in healthy individuals for VLDL ( = 0.001), triglycerides ( = 0.001), CRP ( = 0.003), WBC ( = 0.007), blood sugar ( = 0.002), total cholesterol ( = 0.003), and LDL ( = 0.010). Significantly higher levels of NLRP3 in saliva ( = 0.038) and serum ( = 0.021) were observed in patients with periodontitis than in those without periodontitis. Significant correlations were found between serum NLRP3 levels and the presence of hypertension ( = 0.001) and between saliva IL-1β levels and the presence of hypertension ( = 0.010). Serum NLRP3 levels demonstrated a predictive value for hypertension (AUC 0.693, 95% CI 0.590-0.796, and = 0.001), with an established cutoff value of 0.68 ng/mL (sensitivity 0.623, specificity 0.630). : The higher levels and correlations of pro-inflammatory markers in serum and saliva observed in patients with periodontitis and hypertension support the hypothesis of a relationship between these diseases, likely mediated by low-grade systemic inflammation.

摘要

在过去几十年中，大量证据表明牙周炎与包括高血压在内的全身性疾病有关，但这种关联背后的机制尚未完全明确。本研究旨在确定可能介导这种关系的因素，包括分析患有这两种疾病的患者血清和唾液中的炎症生物标志物NLRP3和IL-1β水平。

本研究纳入了108名个体（平均年龄47.8岁，标准差12.8），男性占38.9%，女性占61.1%。参与者被分为四组：第一组——26名健康参与者；第二组——24名患有牙周炎的参与者；第三组——26名患有高血压的参与者；第四组——32名同时患有牙周炎和高血压的参与者。进行临床检查以诊断高血压和牙周炎，包括对所有患者进行调查和血液检测。使用酶联免疫吸附测定法测量血清和唾液中的NLRP3和IL-1β水平。

患有牙周炎和高血压的患者明显比没有这些疾病的患者年龄更大（分别为P<0.001和P<0.001），并且缺失牙更多（分别为P<0.001和P = 0.037）。牙周炎和高血压组的极低密度脂蛋白（VLDL，P = 0.001）、甘油三酯（P = 0.001）、C反应蛋白（CRP，P = 0.003）、白细胞（WBC，P = 0.007）、血糖（P = 0.002）、总胆固醇（P = 0.003）和低密度脂蛋白（LDL，P = 0.010）水平高于健康个体。牙周炎患者唾液（P = 0.038）和血清（P = 0.021）中的NLRP3水平明显高于无牙周炎患者。血清NLRP3水平与高血压的存在之间存在显著相关性（P = 0.001），唾液IL-1β水平与高血压的存在之间也存在显著相关性（P = 0.010）。血清NLRP3水平对高血压具有预测价值（曲线下面积[AUC]为0.693，95%置信区间[CI]为0.590~0.796，P = 0.001），既定的临界值为0.68 ng/mL（敏感性为0.623，特异性为0.630）。

牙周炎和高血压患者血清和唾液中促炎标志物水平较高及其相关性支持了这些疾病之间存在关联的假设，这种关联可能由低度全身性炎症介导。