慢性牙周炎合并冠心病患者血清Vaspin、Apelin、Chemerin水平与牙周临床指数相关性探讨

Correlation between serum Vaspin,Apelin,Chemerin levels and periodontal clinical index in patients with chronic periodontitis and coronary heart disease

目的:探讨慢性牙周炎(CP)合并冠心病(CHD)患者血清内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、脂肪因子(Apelin)、脂肪因子趋化素(Chemerin)水平与牙周临床指数的关系。方法:选择慢性牙周炎患者160例为研究对象,其中CP合并CHD患者80例为试验组,单纯慢性周炎患者80例为对照组(NC组)。采用酶联免疫吸附法(ELISA)检测并记录所有研究对象血清中Vaspin、Apelin、Chemerin水平,检查测量所有研究对象牙周探诊深度(PD)、牙周附着水平(PAL)、菌斑指数(PI)、探诊出血指数(BI)、牙龈指数(GI),Pearson分析慢性牙周炎合并冠心病患者血清Vaspin、Apelin、Chemerin水平与PD、PAL、PI、BI、GI之间的相关性,Logistic回归分析CP患者发生CHD的危险因素。结果:试验组和NC组在性别、年龄上比较差异无统计学意义(P>0.05),试验组有吸烟史和高血压史的人数显著多于NC组(P<0.05);与NC组比较,试验组Vaspin、Apelin水平较低,Chemerin水平较高(P<0.05);与NC组比较,试验组PD、PAL、PI、BI、GI指数较高(P<0.05);试验组患者血清Vaspin水平与PD、PAL、PI、BI、GI指数呈负相关(P<0.05);Apelin水平与PD、PAL、PI、BI、GI指数呈负相关(P<0.05);Chemerin水平与PD、PAL、PI、BI、GI指数呈正相关(P<0.05);多因素Logistic回归分析显示年龄、高血压史、吸烟史、Chemerin高水平均为影响CP患者发生CHD的独立危险因素,Vaspin、Apelin高水平为独立保护因素(P<0.05)。结论:CP合并CHD患者血清Vaspin、Apelin水平较低、Chemerin水平较高,与患者牙周指数有关,均为CP患者发生CHD的影响因素。

Objective:To investigate the correlation between serum visceral fat-derived serine protease inhibitor(Vaspin),adipokines(Apelin)and adipocyte chemokine(Chemerin)levels and periodontal clinical index in patients with chronic periodontitis(CP)and coronary heart disease(CHD).Methods:160 patients with CP were selected as the research objects,of which 80 patients with CP and CHD were in the experimental group,and 80 patients with simple CP were in the control group(NC group).The levels of serum Vaspin,Apelin and Chemerin were detected by ELISA.The periodontal exploration depth(PD),periodontal attachment level(PAL),plaque index(PI),visiting bleeding index(BI),gingival index(GI)were measured.The correlation between serum Vaspin,Apelin,Chemerin levels and PD,PAL,PI,BI,GI in patients with periodontitis was analyzed by Pearson analysis,and Logistic regression was used to analyze the risk factors of CHD in patients with CP.Results:There was no significant difference in gender and age between the experimental group and the NC group(P>0.05).The numbers of patients with smoking history and hypertension history in the experimental group were significantly higher than those in NC group(P<0.05).Compared with the NC group,the levels of Vaspin and Apelin in the experimental group were lower andthe level of Chemerin was higher(P<0.05).Compared with the NC group,the indexes of PD,PAL,PI,BI and GI in the experimental group were higher(P<0.05).The serum Vaspin level was negatively correlated with the indexes of PD,PAL,PI,BI and GI in the experimental group(P<0.05).Apelin level was negatively correlated with the indexes of PD,PAL,PI,BI and GI(P<0.05).Chemerin level was positively correlated with the indexes of PD,PAL,PI,BI and GI(P<0.05).Multivariate Logistic regression analysis showed that age,hypertension history,smoking history and high level of Chemerin were independent risk factors for CHD in patients with CP,and high levels of Vaspin and Apelin were independent protective factors(P<0.05).Conclusion:The lower levels of serum Vaspin,Apelin and the higher level of serum Chemerin in patients with CP and CHD are related to periodontal index,and they are the influencing factors for the occurrence of CHD in patients with CP.