Țica Otilia, Romanul Ioana, Ciavoi Gabriela, Pantea Vlad Alin, Scrobota Ioana, Șipoș Lucian, Daina Cristian Marius, Țica Ovidiu
Cardiology Clinic, Emergency County Clinical Hospital of Bihor, 410165 Oradea, Romania.
Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania.
Biomedicines. 2025 Sep 20;13(9):2309. doi: 10.3390/biomedicines13092309.
: Diabetes mellitus (DM), periodontal disease (PD), and cardiovascular disease (CVD) are highly prevalent global health conditions with overlapping pathophysiological mechanisms. Emerging evidence suggests a bidirectional and synergistic relationship among them, driven by chronic inflammation, immune dysregulation, oxidative stress, and microbial dysbiosis. : This review synthesizes current literature on the interconnectedness of DM, PD, and CVD, emphasizing shared molecular pathways, clinical implications, and opportunities for integrated management. : A systematic review and narrative synthesis of recent clinical trials, observational studies, and multi-omics investigations was conducted to explore the mechanisms linking these three conditions. A structured literature search was performed across PubMed, Scopus, and Web of Science from database inception until 30 June 2025. Key findings were contextualized within systems biology, precision medicine, and real-world clinical strategies. : DM exacerbates periodontal inflammation and accelerates tissue destruction via hyperglycemia-induced inflammatory mediators, while periodontitis worsens glycemic control and insulin resistance. Both conditions independently elevate cardiovascular risk, and their co-occurrence significantly amplifies the incidence of adverse cardiovascular events. Shared biomarkers such as Interleukin (IL)-6, Tumor Necrosis Factor (TNF)-α, and CRP, as well as overlapping genetic and epigenetic signatures, underscore a common inflammatory axis. Periodontal therapy has demonstrated modest but meaningful benefits on glycemic control and endothelial function, while cardiometabolic therapies (e.g., statins, Glucagon-Like Peptide (GLP-1) receptor agonists, SGLT2 inhibitors) show potential to improve periodontal outcomes. Probiotics, microbiome-targeted therapies, and AI-based risk models are emerging as future tools. : DM, PD, and CVD form a mutually reinforcing triad mediated by systemic inflammation and metabolic dysregulation. Integrated, multidisciplinary care models and precision health strategies are essential to address this inflammatory burden and improve long-term outcomes. Further large-scale interventional trials and mechanistic human studies are needed to establish causal links and optimize combined therapeutic approaches.
糖尿病（DM）、牙周疾病（PD）和心血管疾病（CVD）是全球高度流行的健康问题，其病理生理机制相互重叠。新出现的证据表明，在慢性炎症、免疫失调、氧化应激和微生物群落失调的驱动下，它们之间存在双向协同关系。：本综述综合了关于DM、PD和CVD相互联系的当前文献，强调了共同的分子途径、临床意义以及综合管理的机会。：对近期的临床试验、观察性研究和多组学调查进行了系统综述和叙述性综合分析，以探索连接这三种疾病的机制。从数据库建立到2025年6月30日，在PubMed、Scopus和Web of Science上进行了结构化文献检索。关键研究结果在系统生物学、精准医学和现实世界临床策略的背景下进行了阐述。：DM通过高血糖诱导的炎症介质加剧牙周炎症并加速组织破坏，而牙周炎则会恶化血糖控制和胰岛素抵抗。这两种情况都会独立增加心血管风险，它们同时出现会显著增加不良心血管事件的发生率。白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α和C反应蛋白（CRP）等共同的生物标志物，以及重叠的遗传和表观遗传特征，强调了一个共同的炎症轴。牙周治疗已证明对血糖控制和内皮功能有适度但有意义的益处，而心脏代谢疗法（如他汀类药物、胰高血糖素样肽（GLP）-1受体激动剂、钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂）显示出改善牙周结局的潜力。益生菌、针对微生物群落的疗法和基于人工智能的风险模型正在成为未来的工具。：DM、PD和CVD形成了一个由全身炎症和代谢失调介导的相互强化的三联征。综合、多学科的护理模式和精准健康策略对于应对这种炎症负担和改善长期结局至关重要。需要进一步的大规模干预试验和机制性人体研究来建立因果联系并优化联合治疗方法。
