脂联素在2型糖尿病相关牙周炎中的作用

The role of adiponectin in type 2 diabetes-related periodontitis

脂联素是脂肪细胞分泌的一种脂肪细胞因子,已经成为治疗2型糖尿病的潜在治疗方法。脂联素受体在多种细胞及组织中表达,脂联素通过与其受体结合可发挥调节糖脂代谢、氧化应激、炎症反应和骨代谢等多种生理作用。现有众多研究证实脂联素与2型糖尿病相关的牙周炎存在紧密联系。脂联素可以通过增加胰岛素敏感性、促进胰岛素分泌而改善全身性的胰岛素抵抗,同时通过抑制牙龈卟啉单胞菌脂多糖诱导的促炎细胞因子表达,促进巨噬细胞的M2型极化,从而改善牙周的炎症反应。此外,脂联素通过Wnt/β-catenin、NF-κ等多种途径抑制破骨细胞的分化及成熟,并促进成骨细胞分化参与调节骨代谢,进而改善牙周骨吸收及破坏。因此,脂联素有望成为2型糖尿病相关牙周炎的潜在治疗靶点。然而,由于脂联素的生理特性,其临床应用转化受到了一定的限制。本文就脂联素在2型糖尿病相关牙周炎中的最新研究进展进行综述,旨在阐明脂联素在控制血糖、抗炎和骨代谢方面对2型糖尿病相关牙周炎的可能影响,为该病的治疗及相关药物的研制提供依据。

Adiponectin,an adipocytokine secreted by adipocytes,has emerged as a potential treatment agent for type 2 diabetes.Adiponectin plays a variety of physiological roles in regulating glucolipid metabolism,oxidative stress,inflammatory responses and bone metabolism by binding to its receptors expressed on a variety of cells and tissues.Nu-merous studies have confirmed the strong association of adiponectin with type 2 diabetes-related periodontitis.Adiponec-tin can improve systemic insulin resistance by increasing insulin sensitivity and promoting insulin secretion.It improves the periodontal inflammatory response by inhibiting the expression of proinflammatory cytokines induced by Porphy-romonas gingivalis lipopolysaccharide and promoting M2-type polarization of macrophages.In addition,adiponectin in-hibits osteoclast differentiation and maturation through various pathways,such as Wnt/β-catenin and NF-κ,and pro-motes osteoblast differentiation to regulate bone metabolism,thus improving periodontal bone resorption and destruc-tion.Therefore,adiponectin is expected to become a therapeutic target for type 2 diabetes-related periodontitis.Due to the physiological characteristics of adiponectin,its clinical application has been somewhat limited.This article reviews the latest research progress on adiponectin in type 2 diabetes-related periodontitis,aiming to elucidate the possible ef-fects of adiponectin on type 2 diabetes-related periodontitis in terms of glycemic control,anti-inflammation and bone me-tabolism and to provide some opinions on the treatment of this disease and the development of relevant drugs.