25羟基维生素D3与2型糖尿病合并慢性牙周炎关系的研究  

The relationship between 25 hydroxyvitamin D3 and chronic periodontitis in type 2 diabetes mellitus

作　　者：刘晓明 宋文静 葛少华[2] 张一帆 杨蒙蒙 孙磊[1] LIU Xiaoming;SONG Wenjing;GE Shaohua(Department of Endocrinology,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院内分泌科,济南250012 [2]山东大学口腔医学院牙周科

出　　处：《中国糖尿病杂志》2020年第4期276-280,共5页Chinese Journal of Diabetes

摘　　要：目的探讨25羟基维生素D3[25(OH)D3]及炎症因子与T2DM合并慢性牙周炎(CP)的关系。方法选取2018年3~9月于山东大学齐鲁医院内分泌科就诊的T2DM合并CP患者(T2DM+CP组)40例,同期于山东大学口腔医院就诊的单纯CP患者(CP组)40例及20名健康人群为正常对照组(NC)。ELISA法检测血清与龈沟液(GCF)中25(OH)D3、肿瘤坏死因子α(TNF-α)、白介素1(IL-1)、IL-6、骨保护蛋白(OPG)、核因子κB受体活化因子配体(RANKL)的水平。结果 NC、CP、T2DM+CP组GCF中25(OH)D3水平依次降低(P<0.01)。与NC组比较,CP、T2DM+CP组血清、GCF中炎症因子水平升高,且T2DM+CP组高于CP组(P<0.05)。Pearson相关分析显示,HbA1c与GCF中25(OH)D3水平呈负相关(P<0.01)。GCF中25(OH)D3水平与OPG/RANKL呈正相关(P<0.01)。结论维生素D与炎症因子水平及机体组织健康相关,糖尿病合并CP患者25(OH)D3水平明显降低,在发病过程中起一定作用,T2DM进一步降低局部25(OH)D3水平并加重机体炎症状况。Objective To explore the relationship between 25 hydroxyvitamin D3[25(OH)D3],the inflammatory factors and patients with type 2 diabetes mellitus(T2DM)and chronic periodontitis(CP).Methods A total of 100 subjects were enrolled in this study,and divided into three group:T2DM patients complicated with chronic periodontitis from March to September,2018(T2DM+CP group,n=40)treatment in Department of Endocrinology,Qilu Hospital of Shandong University,patients with chronic periodontitis without diabetes(CP group,n=40)and healthy volunteers with healthy periodontal tissues and no systemic disease from Shandong University Stomatological Hospital(NC group,n=20).The level of 25(OH)D3,tumor necrosis factor(TNF-α),interleukin 1(IL-1),IL-6,osteoprotegerin(OPG),receptor activator of NF-κB ligand(RANKL)in serum and gingival crevicular fluid(GCF)were tested by Enzyme-linked immuResults The levels of serum 25(OH)D3 in NC group,CP group and T2DM+CP group decreasedin turn(P<0.01).The inflammatory factors in GCF were higher in CP and T2DM+CP group than in NC group,and highest in T2DM+CP group(P<0.05).The level of HbA1c was negatively correlated with 25(OH)D3 in GCF(P<0.01).The level of 25(OH)D3 in GCF was positively correlated with OPG/RANKL ratio(P<0.01).Conclusion Vitamin D levels and inflammation were related with tissue health.The level of 25(OH)D3 was significantly lower in T2DM patients with chronic periodontitis.25(OH)D3 had a certain effect in the pathogenesis of diabetic chronic periodontitis.T2DM further reduced the local25(OH)D3 levels and increase the body’s inflammatory conditions.

关 键 词：25羟基维生素D3 糖尿病 2型 慢性牙周炎 骨保护蛋白/核因子κB受体活化因子配体 炎症因子 

分 类 号：R587.2[医药卫生—内分泌] R781.42[医药卫生—内科学]