Selvaraj Teena, Mahendra Jaideep, Ravi Nikita, Dave Pavithra H, Bedi Muskan, Rao Sivaraj Moti Ram, Yadalam Pradeep K, Ardila Carlos M
Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India.
Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.
Clin Oral Investig. 2025 Sep 8;29(10):441. doi: 10.1007/s00784-025-06514-y.
This study aims to assess periodontal and biochemical parameters and evaluate the salivary Protectin D1 levels in periodontitis patients with and without metabolic syndrome after non-surgical periodontal therapy.
Forty patients were categorized into two groups: 20 patients in Group P (systemically healthy patients with stage II/III grade B periodontitis) and 20 patients in Group P+MS (patients with stage II/III grade B periodontitis and metabolic syndrome). Parameters including age, gender, height, weight, body mass index, waist circumference, socio-economic status, oral hygiene index (OHI), modified gingival index (MGI), probing pocket depth, clinical attachment levels, fasting blood glucose, HDL-c, total triglycerides, and blood pressure were recorded. Saliva samples were collected before scaling and root planing (PMPR). Full-mouth subgingival instrumentation (SGI) was performed on day 10, followed by reassessment on day 30.
Demographic and baseline periodontal parameters were significantly higher in the P+MS group compared to the P group (p < 0.001). Both groups showed significant improvement in periodontal parameters after PMPR and SGI by the 30th day (p < 0.01). Salivary Protectin D1 levels increased significantly in both groups after treatment (p < 0.01), although no significant difference was observed between the groups at baseline and the 30th day. Protectin D1 levels positively correlated with HDL-c, blood pressure, and MGI at baseline, and with OHI, MGI, PPD, and CAL on the 30th day, but showed no significant association with periodontal parameters.
Periodontitis patients with metabolic syndrome exhibited worse baseline periodontal and biochemical profiles than periodontitis-only patients. Non-surgical periodontal therapy significantly improved periodontal health in both groups, with a concurrent increase in salivary PD1 levels, though no intergroup difference in PD1 expression was observed. While PD1 correlated with HDL-c, blood pressure, and periodontal indices, it did not differentiate the therapeutic response between groups, suggesting PD1 may reflect general resolution of inflammation rather than MS-specific pathways. Further research is needed to elucidate the role of PD1 in periodontitis with comorbid metabolic syndrome.
Protectin D1 holds promise as a biomarker for the effective management of periodontitis and metabolic syndrome, potentially aiding in both diagnosis and treatment strategies.
本研究旨在评估非手术牙周治疗后伴有和不伴有代谢综合征的牙周炎患者的牙周和生化参数，并评估唾液中保护素D1水平。
40例患者分为两组：P组20例（患有II/III级B型牙周炎的全身健康患者）和P+MS组20例（患有II/III级B型牙周炎和代谢综合征的患者）。记录包括年龄、性别、身高、体重、体重指数、腰围、社会经济状况、口腔卫生指数（OHI）、改良牙龈指数（MGI）、探诊袋深度、临床附着水平、空腹血糖、高密度脂蛋白胆固醇、总甘油三酯和血压等参数。在龈上洁治和根面平整（PMPR）前采集唾液样本。在第10天进行全口龈下器械操作（SGI），然后在第30天进行重新评估。
与P组相比，P+MS组的人口统计学和基线牙周参数显著更高（p<0.001）。两组在第30天PMPR和SGI后牙周参数均有显著改善（p<0.01）。治疗后两组唾液保护素D1水平均显著升高（p<0.01），尽管在基线和第30天两组之间未观察到显著差异。保护素D1水平在基线时与高密度脂蛋白胆固醇、血压和MGI呈正相关，在第30天与OHI、MGI、PPD和CAL呈正相关，但与牙周参数无显著关联。
患有代谢综合征的牙周炎患者的基线牙周和生化状况比仅患有牙周炎的患者更差。非手术牙周治疗显著改善了两组的牙周健康，同时唾液PD1水平升高，尽管在PD1表达上未观察到组间差异。虽然PD1与高密度脂蛋白胆固醇、血压和牙周指数相关，但它并未区分两组之间的治疗反应，这表明PD1可能反映炎症的总体消退而非代谢综合征特异性途径。需要进一步研究以阐明PD1在合并代谢综合征的牙周炎中的作用。
保护素D1有望作为有效管理牙周炎和代谢综合征的生物标志物，可能有助于诊断和治疗策略。
