缺氧诱导因子-1α在糖尿病伴牙周炎患者牙周组织中的表达及其与牙龈微循环障碍的关系

Expression of Hypoxia Inducible Factor-1αin Periodontal Tissues of Diabetic Patients with Periodontitis and Its Rela-tionship with Gingival Microcirculation Disorder

目的:探究缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)在糖尿病伴牙周炎患者牙周组织中的表达特点以及HIF-1α与牙龈微循环参数的关系。方法:选择2019年3月~2022年3月于我院就诊的2型糖尿病患者237例作为研究对象,根据患者是否合并牙周炎分为合并牙周炎组(105例)和未合并牙周炎组(132例)。Logistic回归模型分析HIF-1α表达水平与糖尿病患者合并牙周炎的风险关系。限制性立方样条模型分析HIF-1α与牙周炎发生剂量-反应关系。多因素Logistic回归分析糖尿病患者合并牙周炎发生的影响因素。Cox回归分析HIF-1α、牙龈微循环参数的交互作用。建立结构方程预测模型并进行验证。结果:校正混杂因素后,HIF-1α与糖尿病患者合并牙周炎呈正相关。HIF-1α表达水平和糖尿病患者合并牙周炎不存在非线性剂量-反应关系,和性别无关。HIF-1α、牙龈微循环参数等是牙周炎发生的重要影响因素。HIF-1α和牙龈微循环参数的交互作用会增加糖尿病患者合并牙周炎的发病风险。HIF-1α联合牙龈血流量的交互效应最高。结构方程模型整体适配情况较优,能很好地反映各影响因素与牙周炎发生的关系。预测模型区分度、独立性较好。结论:HIF-1α是糖尿病患者合并牙周炎的危险因素。HIF-1α和牙龈微循环参数交互作用会增加糖尿病患者合并牙周炎的发病风险。

Objective:To investigate the expression characteristics of hypoxia inducible factor-1α(HIF-1α)in periodontal tissues of diabetic patients with periodontitis and the relationship between HIF-1αand gingival microcirculation parameters.Methods:A total of 237 patients with type 2 diabetes who were treated in our hospital from March 2019 to March 2022 were selected as the study objects.According to whether the patients had periodontitis or not,they were divided into the group with periodontitis(105 cases)and the group without periodontitis(132 cases).Logistic regression model was used to analyze the relationship between the expression level of HIF-1αand the risk of periodontitis in diabetic patients.The dose-response relationship between HIF-1αand periodontitis was analyzed by restricted cubic spline model.Multivariate logistic regression analysis was used to analyze the factors affecting the occurrence of periodontitis in diabetic patients.The interaction of HIF-1αand gingival microcirculation parameters was analyzed by Cox regression.The structural equation prediction model was established and verified.Results:After adjusting for confounding factors,HIF-1αwas positively correlated with periodontitis in diabetic patients.The expression level of HIF-1αwas not nonlinear dose-response related to diabetic patients with periodontitis,and was not related to gender.HIF-1αand gingival microcirculation parameters were important factors affecting the occurrence of periodontitis.The interaction of HIF-1αand gingival microcirculation parameters might increase the risk of periodontitis in diabetic patients.The interaction effect of HIF-1αcombined with gingival blood flow was the highest.The overall adaptation of structural equation model was better,which could reflect the relationship between the influencing factors and the occurrence of periodontitis.The prediction model had good differentiation and independence.Conclusion:HIF-1αis a risk factor for periodontitis in diabetic patients.The interaction of HIF-1αand gingival microcirculation parameters may increase the risk of periodontitis in diabetic patients.