冠状动脉粥样硬化患者牙周炎患病情况与外周血胆碱代谢物水平相关性研究  

Relationship between the prevalence of periodontitis and the level of choline metabolites in peripheral blood of patients with coronary atherosclerosis

作　　者：王艳 周欣 黄玲燕 李兵[1] 吴娟[1] 杨洁[1] 李益民 解伟格 谢思静[1] WANG Yan;ZHOU Xin;HUANG Ling-yan;LI Bing;WU Juan;YANG Jie;LI Yi-min;XIE Wei-ge;XIE Si-jing(Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210000,China;Huai′an Stomatological Hospital,Huai′an 223001,China;Suzhou Stomatological Hospital,Suzhou 215000,China;不详)

机构地区：[1]南京大学医学院附属口腔医院·南京市口腔医院,江苏南京210000 [2]淮安市口腔医院,江苏淮安223001 [3]苏州口腔医院,江苏苏州215000 [4]南京医科大学邵逸夫医院,江苏南京210000

出　　处：《中国实用口腔科杂志》2023年第6期694-699,共6页Chinese Journal of Practical Stomatology

基　　金：国家自然科学基金(81801041);南京市卫生科技发展专项资金重点项目(ZKX21055)。

摘　　要：目的研究在冠状动脉粥样硬化患者中牙周炎患病情况与外周血胆碱代谢物水平的相关性。方法选取2018—2020年于南京市胸科医院确诊的冠状动脉粥样硬化患者66例,经口腔检查后将患者分为牙周炎组(45例)和牙周健康组(21例),比较两组患者基本信息(年龄、体质指数、性别、吸烟状况及外周血血糖、低密度脂蛋白、高密度脂蛋白、甘油三酯、C反应蛋白水平)。采用液相色谱串联质谱法检测患者外周血胆碱代谢物[三甲胺(TMA)、氧化三甲胺(TMAO)、甜菜碱、胆碱、肌酸酐、左旋胆碱]水平,并采用四分位数的有序回归分析冠状动脉粥样硬化患者牙周炎患病情况与胆碱代谢物水平的相关性。结果两组患者基本信息的比较,差异均无统计学意义(均P>0.05);对两组患者外周血胆碱代谢物的检测发现,牙周炎组外周血TMAO水平[12.97(8.85,18.17)ng/mL]高于牙周健康组[5.81(3.23,10.62)ng/mL],差异有统计学意义(Z=-3.297,P=0.001)。四分位数有序回归分析结果显示,冠状动脉粥样硬化患者外周血TMAO水平与牙周炎患病情况存在相关性(95%CI:-2.589~-0.334,P=0.011)。结论冠状动脉粥样硬化合并牙周炎的患者外周血TMAO水平升高,提示牙周炎可能通过影响TMA代谢途径促进动脉粥样硬化的发展。Objective To study the correlation between the prevalence of periodontitis and choline metabolite levels in peripheral blood of patients with coronary atherosclerosis.Methods Totally 66 patients with coronary atherosclerosis diagnosed in Nanjing Chest Hospital from 2018 to 2020 were selected,and the patients were divided into the periodontitis group(45 patients)and the health group(21 patients)according to the oral examination results.The basic information of the two groups(age,body mass index,gender,smoking status,and peripheral blood glucose,low-density lipoprotein,high-density lipoprotein,triglyceride,and C-reactive protein levels)was compared.The level of peripheral blood choline metabolites[trimethylamine(TMA),trimethylamine N-oxide(TMAO),betaine,choline,creatinine,L-choline]was measured by liquid chromatography tandem mass spectrometry.The correlation between the prevalence of periodontitis and the levels of choline metabolites in patients with coronary atherosclerosis was studied via ordered regression analysis for the quartiles.Results The basic information showed no statistically significant differences between the two groups(P>0.05).TMAO levels of peripheral blood in the periodontitis group[12.97(8.85,18.17)ng/mL]was higher than that in the health group[5.81(3.23,10.62)ng/mL],and the difference was statistically significan(tZ=-3.297,P=0.001).Ordered regression analysis showed that patients′periodontal condition was correlated with the peripheral blood TMAO levels(95%CI:-2.589--0.334,P=0.011).Conclusion Elevated peripheral blood TMAO level in patients with coronary atherosclerosis combined with periodontitis suggests that periodontitis may promote the development of atherosclerosis by affecting the TMA metabolic pathway.

关 键 词：氧化三甲胺 牙周炎 冠状动脉粥样硬化 

分 类 号：R78[医药卫生—口腔医学]