伴肥胖牙周炎患者脂代谢水平及其与牙周炎的相关性分析  

Analysis of lipid metabolism and its correlation with periodontitis in patients with obesity and periodontitis

作　　者：张雨薇 王志瑜[2] 胡波[1] 王珍珍[1] 贾如 ZHANG Yuwei;WANG Zhiyu;HU Bo;WANG Zhenzhen;JIA Ru(Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research/Laboratory Center of Stomatology/Department of Prosthodontics,College of Stomatology,Xi’an Jiaotong University,Xi’an,Shaanxi 710004,China;Department of stomatology,Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710049,China)

机构地区：[1]西安交通大学口腔医院陕西省颅颌面精准医学研究重点实验室/陕西省牙颌疾病临床研究中心/西安交通大学口腔医院修复科,西安710004 [2]西安交通大学医院口腔科,西安710049

出　　处：《重庆医学》2023年第11期1659-1664,共6页Chongqing medicine

基　　金：陕西省自然科学基金青年项目(2020JQ-565);中央高校基本科研业务费专项资金(xzy012019106)。

摘　　要：目的探讨伴不同肥胖状态牙周炎患者牙周炎临床指标、血清脂代谢水平、脂肪因子分泌水平及其相关性。方法本研究根据最新国际牙周病学共识指南分类标准共纳入82例Ⅰ期及Ⅱ期牙周炎患者,并根据体重指数(BMI)分为体重正常组(BMI 18.5~≤25.0 kg/m^(2),n=26),超重组(BMI>25.0~30.0 kg/m^(2),n=28)及肥胖组(BMI>30.0 kg/m^(2),n=28)。记录患者的一般信息,采集血清与龈沟液样本,检查并记录指数牙牙周临床指标。采用酶联免疫吸附试验(ELISA)或生化检测法测定血清及龈沟液中相关指标,对数据进行统计学检验及相关性分析。结果肥胖组及超重组的空腹血糖(FPG)及糖化血红蛋白(HbA1c)水平与正常组比较,差异均无统计学意义(P>0.05);但肥胖组及超重组的牙周探诊深度(PD)、附着丧失水平(CAL)及龈沟液炎性因子的分泌水平均高于正常组(P<0.05),肥胖组的血清内脂素、瘦素及抵抗素水平明显高于正常组及超重组(P<0.05),而脂联素水平明显低于正常组及超重组(P<0.05)。相关性分析结果显示,患者牙周PD、CAL与BMI及腰臀比(WHR)呈正相关(P<0.001),而血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及内脂素、瘦素、抵抗素水平等与牙周炎亦明显相关(P<0.05)。结论伴肥胖患者较体重正常患者牙周炎程度更重,且牙周炎症程度随肥胖程度的增加而增加;肥胖可能通过调控脂肪因子的分泌水平加重对牙周组织的破坏。Objective To investigate the clinical indexes of periodontitis,serum lipid metabolism and adipokines secretion levels in patients with different obesity and periodontitis status and their correlations.Methods A total of 82 patients with stage I and II periodontitis were enrolled according to the latest international consensus guidelines on periodontitis classification in this study.According to the body mass index(BMI),they were divided into the normal body weight group(BMI 18.5-≤25.0 kg/m^(2),n=26),the overweight group(BMI>25-30.0 kg/m^(2),n=28)and the obesity group(BMI>30 kg/m^(2),n=28).The general information of patients was recorded,serum and gingival crevicular fluid(GCF)samples were collected,and periodontal clinical indicators were examined and recorded.Enzyme-linked immunosorbent assay(ELISA)or biochemical detection were used to determine the relevant indexes in serum and gingival crevicular fluid,and statistical test and correlation analysis were performed.Results The fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)levels of the obesity group and the overweight group were not statistically different from the normal body weight group(P>0.05).The depth of periodontal pocket(PD),the level of attachment loss(CAL)and the secretion of inflammatory cytokines in GCF in the obesity group and the overweight group were higher than those in the normal body weight group(P<0.05).The serum levels of visfatin,leptin and resistin in the obesity group were significantly higher than those in the normal body weight group and the overweight group(P<0.05),while the adiponectin level was significantly lower than that of the normal body weight group and the overweight group(P<0.05).Correlation analysis showed that PD and CAL were positively correlated with BMI and waist-to-hip ratio(WHR)(P<0.001).The serum levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),visfatin,leptin and resistin were significantly correlated with periodontitis(P<0.05).Conclusion The degree of periodon

关 键 词：牙周炎 肥胖 脂代谢 炎性因子 脂肪因子 

分 类 号：R781.42[医药卫生—口腔医学]