2型糖尿病伴慢性牙周炎病人的血糖和炎性因子水平与牙周病变程度的相关性分析

The relationship between blood sugar and inflammatory factors with the severity ofdisease of type 2 diabetes mellitus and chronic periodontitis

目的探讨血糖水平、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和前列腺素-2(PGE-2)炎性因子水平与糖尿病伴慢性牙周炎病人牙周病变程度的相关性。方法选择2型糖尿病伴慢性牙周炎病人102例。检测血清TNF-α、IL-1、IL-6和PGE-2。检测血浆糖化血红蛋白(HbA_1C)水平,以Hb A1C和胰岛素抵抗指数评估糖尿病病变程度,以牙龈指数评估牙周炎病变程度。分析血糖水平、TNF-α、IL-1、IL-6和PGE-2炎性因子水平与糖尿病伴慢性牙周炎病人疾病严重程度的相关性。结果轻、中、重度Hb A1C组牙龈指数等级分布差异有统计学意义(P<0.05),Person相关性检验结果显示血糖水平与牙龈指数等级存在显著正相关(P<0.05)。任意两组牙龈指数等级比较,胰岛素抵抗指数均差异有统计学意义,两者呈显著正相关(r=0.468,P=0.009)。任意两组牙龈指数等级比较,血清TNF-α、IL-1、IL-6和PGE-2水平均差异有统计意义(P<0.05),血清各炎性因子与牙龈指数等级差异有统计学意义(r=0.211,P=0.044;r=0.354,P=0.023;r=0.396,P=0.017;r=0.538,P=0.011)。结论 2型糖尿病伴慢性牙周炎病人的血糖水平和血清TNF-α、IL-1、IL-6和PGE-2炎性因子水平与牙周病变程度呈显著正相关,治疗此类病人应该兼顾控制血糖和消除炎症。

Objective To investigate the relationship between the levels of blood glucose, tumor necrosis factor alpha （TNF-α） , interleukin-1 （IL-1 ） , interleukin-6 （ IL-6 ） and prostaglandin -2 （PG E -2 ） with the severity of disease in patients with diabetes mellitus and chronic periodontitis. Methods 102 cases type 2 diabetes mellitus complicated with chronic periodontitis in our hospital were selected. Serum TNF-α, IL-1 , IL-6 and PGE-2 were detected. The level of plasma glycosylated hemoglobin （HbA1c） was measured to evaluate the degree of diabetes mellitus with insulin resistance index. The degree of periodontitis was evaluated with gingival index. The relationship between the levels of blood glucose, TNF-α, IL-1 , IL-6 and PGE-2 inflammatory factors and the severity of disease in patients with diabetes mellitus and chronic periodontitis was analyzed. Results In mild, moderate and severe HbAlc group, there was a significant difference in the gingival index grades. The result of Person correlation test showed that there was a significant positive correlation between the level of blood glucose and the gingival index （ P 〈 0. 05 ）. There were significant differences in the indexes of the two groups （ P 〈 0. 0 5 ） and the two groups were significantly positively correlated （ r = 0. 468 ,P = 0. 009）. Compared with the gingival index between any of two groups of level, there were significant difference of serum TNF-α, IL-1 , IL-6 and PGE-2 （ P〈 0. 05 ） . The serum inflammatory factor and the gingival index level showed significant positive correlation （ r = 0. 211 ,P = 0.044 ; r = 0. 354 , P = 0. 023 ; r = 0. 396 , P = 0. 017 ; r = 0. 538 , P = 0. 011 ） . Conclusion The level of blood glucose and serum levels of TNF-a, IL-1 , IL-6 , PGE-2 and were positively correlated with the de-gree of periodontal disease in type 2 diabetes mellitus combined periodontits patients. Treatment of such patients should take into account both the control of blood sugar and the elimination of inflammation.