T2DM伴慢性牙周炎患者龈沟液中hBD-2 hBD-3 LPS与牙周健康指标的关系

Relationship between Gingival Crevicular Fluid Levels of hBD-2 hBD-3 LPS and Periodontal Health Indicators in Patients with Type 2 Diabetes Mellitus and Chronic Periodontitis

目的:探讨2型糖尿病(T2DM)伴慢性牙周炎的患者龈沟液中β防御素(hBD-2、hBD-3)、脂多糖(LPS)的变化及与牙周健康指标的相关性。方法:本研究经医学伦理委员会批准后实施,将本院2020年1月至2022年12月确诊的120例T2DM且合并慢性牙周炎患者作为A组、另外选取120例不患T2DM的慢性牙周炎患者作为B组、不患T2DM的牙周健康对象120例作为C组,检测三组龈沟液hBD-2、hBD-3、LPS水平、口腔科牙周健康相关指标、口腔龈下菌群情况,分析T2DM伴慢性牙周炎患者hBD-2、hBD-3、LPS与牙周健康指标、口腔龈下菌群数量指标的相关性。结果:A、B、C三组的龈沟液中hBD-2、hBD-3、LPS测定结果差异具有统计学意义(P<0.05);其中A组的hBD-2、hBD-3低于B组、C组,LPS高于B组、C组;B组的hBD-2、hBD-3低于C组,LPS高于C组,差异均具有统计学意义(P<0.05);A、B、C三组的PD、SBI、CAL、GCF测定结果差异具有统计学意义(P<0.05);其中A组的PD、SBI、CAL、GCF高于B组、C组;B组PD、SBI、CAL、GCF高于C组,差异均具有统计学意义(P<0.05);A、B、C三组的牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌测定结果差异具有统计学意义(P<0.05);其中A组的牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌高于B组、C组;B组牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌高于C组,差异均具有统计学意义(P<0.05)。T2DM伴慢性牙周炎患者龈沟液中hBD-2、hBD-3与PD、SBI、CAL、GCF均呈显著负相关关系,LPS与PD、SBI、CAL、GCF呈显著正相关关系(P<0.05)。结论:T2DM伴慢性牙周炎患者龈沟液中hBD-2、hBD-3水平显著降低、LPS显著升高,并且与牙周健康指标恶化具有密切关系。

Objective:To explore changes inβ-defensins(hBD-2,hBD-3),lipopolysaccharides(LPS)in gingival crevicular fluid(GCF),and their correlation with periodontal health indicators in patients with type 2 diabetes mellitus(T2DM)and chronic periodontitis.Methods:This study,approved by the Medical Ethics Committee,included 120 patients diagnosed with T2DM and chronic periodontitis(Group A),120 chronic periodontitis patients without T2DM(Group B),and 120 periodontally healthy individuals without T2DM(Group C),between January 2020 and December 2022.GCF levels of hBD-2,hBD-3,LPS,oral and periodontal health-related indicators,and subgingival bacterial flora were measured.The correlation between hBD-2,hBD-3,LPS,and periodontal health indicators in T2DM patients with chronic periodontitis was analyzed.Results:The GCF levels of hBD-2,hBD-3,and LPS in Groups A,B,and C showed significant differences(P<0.05).In Group A,hBD-2,hBD-3 were lower than in Groups B and C,while LPS was higher than in Groups B and C.Group B had lower hBD-2,hBD-3 compared to Group C,and higher LPS than Group C(P<0.05).Periodontal parameters including PD,SBI,CAL,GCF in Groups A,B,and C showed significant differences(P<0.05).Group A had higher values than Groups B and C,and Group B had higher values than Group C(P<0.05).The levels of Porphyromonas gingivalis,Aggregatibacter actino-mycetemcomitans,Prevotella intermedia,and Tannerella forsythia in Groups A,B,and C differed significant-ly(P<0.05).Group A had higher levels compared to Groups B and C,and Group B had higher levels com-pared to Group C(P<0.05).Significant negative correlations were found between GCF hBD-2,hBD-3,and PD,SBI,CAL,GCF,while LPS showed a significant positive correlation with these parameters(P<0.05).Conclusion:GCF levels of hBD-2,hBD-3 significantly decrease,and LPS significantly increase in T2DM patients with chronic periodontitis,showing a close relationship with the deterioration of periodontal health in-dicators.