慢性牙周炎患者血清Klotho、FGF23、IGF-1水平的表达及其临床意义

Expression and Clinical Significance of Serum Klotho,FGF23 and IGF-1 Levels in Patients with Chronic Periodontitis

目的:探讨慢性牙周炎(CP)患者血清Klotho、成纤维细胞生长因子23(FGF23)、胰岛素样生长因子-1(IGF-1)水平的表达及其临床意义。方法:选择2022年1月至2023年6月我院收治的108例CP患者(CP组),另选取同期92例于我院行超声波洁牙的口腔健康者(对照组),根据CP病情程度将CP患者分为轻度组(55例)和中重度组(53例)。检测CP组和对照组的血清Klotho、FGF23、IGF-1、炎症因子白细胞介素(IL)-6、IL-1β和肿瘤坏死因子-α(TNF-α)水平,并检查CP组牙周临床指标探诊深度(PD)、附着丧失(CAL),出血指数(BI)。Pearson法分析血清Klotho、FGF23、IGF-1与牙周临床指标以及炎症因子的相关性。受试者工作特征(ROC)曲线分析血清Klotho、FGF23、IGF-1诊断CP的价值。结果:CP组血清FGF23和IL-6、IL-1β、TNF-α水平高于对照组(P<0.05),血清Klotho、IGF-1水平低于对照组(P<0.05)。中重度组血清FGF23和IL-6、IL-1β、TNF-α水平、PD、CAL、BI高于轻度组(P<0.05),血清Klotho、IGF-1水平低于轻度组(P<0.05)。CP患者的血清FGF23水平与IL-6、IL-1β、TNF-α、PD、CAL、BI呈正相关(P<0.05),血清Klotho、IGF-1水平与IL-6、IL-1β、TNF-α、PD、CAL、BI呈负相关(P<0.05)。血清Klotho、FGF23、IGF-1单独诊断CP的曲线下面积为0.819、0.816、0.861,三指标联合诊断曲线下面积为0.978,高于各指标单独诊断。结论:CP患者血清FGF23水平升高,Klotho、IGF-1水平降低与牙周炎症和组织破坏的发生有关,联合检测血清Klotho、FGF23、IGF-1对CP诊断具有较高价值。

Objective:To investigate the expression and clinical significance of serum Klotho,fibroblast growth factor 23(FGF23)and insulin-like growth factor-1(IGF-1)in patients with chronic periodontitis(CP).Methods:108 patients with CP(CP group)who admitted to our hospital from January 2022 to June 2023 were selected,and 92 patients with oral health who underwent ultrasonic tooth cleaning in our hospital during the same period were selected(control group),CP patients were divided into mild group(55 cases)and moderate to severe group(53 cases)according to the severity of CP.The levels of serum Klotho,FGF23,IGF-1,inflammatory factors interleukin(IL)-6,IL-1βand tumor necrosis factor-α(TNF-α)in CP group and control group were detected,and the periodontal clinical indicators of probing depth(PD),attachment loss(CAL)and bleeding index(BI)in CP group were examined.The correlation between serum Klotho,FGF23,IGF-1 and periodontal clinical indicators and inflammatory factors were analyzed by Pearson method.The value of serum Klotho,FGF23 and IGF-1 in the diagnosis of CP were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of serum FGF23,IL-6,IL-1βand TNF-αin CP group were higher than those in control group(P<0.05),and the levels of serum Klotho and IGF-1 were lower than those in control group(P<0.05).The levels of serum FGF23,IL-6,IL-1β,TNF-α,PD,CAL and BI in moderate to severe group were higher than those in mild group(P<0.05),and the levels of serum Klotho and IGF-1 were lower than those in mild group(P<0.05).The level of serum FGF23 of CP patients was positively correlated with IL-6,IL-1β,TNF-α,PD,CAL and BI(P<0.05),and the serum Klotho and IGF-1 levels were negatively correlated with IL-6,IL-1β,TNF-α,PD,CAL and BI(P<0.05).The area under the curve of serum Klotho,FGF23 and IGF-1 in the diagnosis of CP was 0.819,0.816 and 0.861,respectively,the area under the curve of the combined diagnosis of the three indexes was 0.978,which was higher than that of the single diagnosis of each index.Conclusion:The increase of serum FGF23 level,and the decrease of Klotho and IGF-1 levels in CP patients are related to the occurrence of periodontal inflammation and tissue destruction,the combined detection of serum Klotho,FGF23 and IGF-1 has high value in the diagnosis of CP.