2型糖尿病牙周炎患者血清LEP水平与HbA1c的相关

The Correlation Between Serum LEP Level and HbA1c Index in Type 2 Diabetes Mellitus Patients with Periodontitis

目的检测2型糖尿病伴牙周炎、慢性牙周炎、健康体检者血清中瘦素(leptin,LEP)水平、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的变化,为研究糖尿病牙周炎临床治疗提供理论依据。方法随机选取健康体检者组(A组)、慢性牙周炎患者组(B组)和2型糖尿病伴牙周炎患者组(C组),每组30例,记录所有检查者的牙周临床指标:牙周袋探诊深度(probing depth,PD)、牙周附着水平(attachment loss,AL)、菌斑指数(plaque index,PLI)及探诊出血(bleeding on probing,BOP)。运用高效液相层析法检测糖化血红蛋白(HbA1c)指标表达情况,同时用酶联免疫吸附法(ELISA)检测血清中LEP、TNF-α水平表达情况。结果2型糖尿病牙周炎组血清中HbA1c、LEP、TNF-α浓度均明显高于慢性牙周炎患者组、健康体检者组(P<0.05);慢性牙周炎者组与健康体检者组相比,除HbA1c水平无明显的差别外(P>0.05),血清中LEP、TNF-α浓度均有明显的差别(P<0.05)。全部检查者中,HbA1c水平与各牙周临床指标及血清中LEP、TNF-α水平表达均呈正相关性(P<0.05)。结论在2型糖尿病伴牙周炎患者的发病过程,血清中LEP、TNF-α可能作为一种炎症标志因子参与表达,其可能成为治疗糖尿病牙周炎的一个新方向。

Objective To detect the levels of serum LEP and tumor necrosis factor-α(TNF-α)in type 2 diabetes patients with periodontitis,chronic periodontitis and healthy subjects so as to provide theoretical basis for clinical treatment of diabetic periodontitis.Methods The healthy subjects(group A),patients with chronic periodontitis(group B)and patients with type 2 diabetes mellitus with periodontitis(group C)were randomly selected,with 30 patients in each group.The periodontal clinical indicators of all the subjects were recorded,including the depth of periodontal pocket probing,periodontal attachment level,plaque index and probing bleeding.The expression of glycated hemoglobin(HbA1c)was detected by HPLC,and the levels of LEP and TNF-αin serum were detected by enzymoly-linked immunosorbent assay(ELISA).Results The serum levels of HbA1c,LEP and TNF-αin type 2 diabetic periodontitis group were significantly higher than those in chronic periodontitis group and healthy subjects(P<0.05);there was no significant difference in serum LEP and TNF-αlevels between chronic periodontitis group and healthy group(P<0.05),except HbA1c level(P>0.05).HbA1c level was positively correlated with periodontal clinical indicators and serum LEP and TNF-αlevels(P<0.05).Conclusion Serum LEP and TNF-αmay be involved in the expression of inflammatory markers in type 2 diabetes patients with periodontitis,which may become a new direction for the treatment of diabetic periodontitis.