阻塞性睡眠呼吸暂停与牙周病中的唾液基因表达及全身炎症标志物

文献信息

中文摘要

背景： 评估牙周状态是否调节阻塞性睡眠呼吸暂停（OSA）患者的全身低度炎症及唾液分子生物标志物的表达。
方法： 开展了一项横断面观察性研究，纳入113例患者，分为三组：牙周炎组（n=52）、OSA伴牙周炎组（n=30）和OSA不伴牙周炎组（n=31）。分析外周血中的全身炎症标志物，包括白细胞介素-6（IL-6）、高敏C反应蛋白（CRP）、纤维蛋白原、中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、血小板与白细胞比值（PLR）和高密度脂蛋白（HDL）。通过定量实时聚合酶链反应（qPCR）测定瘦素（LEP）、瘦素受体（LEPR）和C-C基序趋化因子配体2（CCL2）的唾液mRNA表达。评估生物标志物、牙周参数与OSA严重程度之间的关联。
结果： OSA伴牙周炎患者的IL-6（p<0.001）和纤维蛋白原（p<0.05）水平显著更高，而CRP呈升高趋势但未达到统计学显著性。在OSA患者中，唾液LEP mRNA表达与氧减饱和指数（ODI）呈负相关（r = -0.627；p = 0.044）。在存在牙周病时，观察到唾液LEP、LEPR和CCL2表达增加的趋势。
结论： OSA与牙周病共存与更明显的全身炎症特征及唾液生物标志物表达改变的趋势相关。

英文摘要

BACKGROUND: To evaluate whether periodontal status modulates systemic low-grade inflammation and the expression of salivary molecular biomarkers in patients with obstructive sleep apnea (OSA).
MATERIALS AND METHODS: A cross-sectional observational study was conducted in 113 patients distributed into three groups: periodontitis (n=52), OSA with periodontitis (n=30), and OSA without periodontitis (n=31). Systemic inflammatory markers were analyzed in peripheral blood, including interleukin-6 (IL-6), high-sensitivity C-reactive protein (CRP), fibrinogen, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-leukocyte ratio (PLR), and high-density lipoprotein (HDL). Salivary mRNA expression of leptin (LEP), leptin receptor (LEPR), and C-C motif chemokine ligand 2 (CCL2) was determined by quantitative real-time polymerase chain reaction (qPCR). Associations between biomarkers, periodontal parameters, and OSA severity were assessed.
RESULTS: Patients with OSA and periodontitis showed significantly higher levels of IL-6 (p<0.001) and fibrinogen (p<0.05), whereas CRP showed an increasing trend without reaching statistical significance. In patients with OSA, salivary LEP mRNA expression was negatively correlated with the oxygen desaturation index (ODI) (r = -0.627; p = 0.044). A trend toward increased salivary expression of LEP, LEPR, and CCL2 was observed in the presence of periodontal disease.
CONCLUSIONS: The coexistence of OSA and periodontal disease is associated with a more pronounced systemic inflammatory profile and a trend toward altered expression of salivary biomarkers.