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北京大学学报（医学版） ›› 2024, Vol. 56 ›› Issue (2): 332-337. doi: 10.19723/j.issn.1671-167X.2024.02.021

• 论著 • 上一篇    下一篇

Ⅲ期或Ⅳ期牙周炎患者龈沟液中有机酸浓度与牙周炎的关系

胡玉如,刘娟,李文静,赵亦兵,李启强,路瑞芳*(),孟焕新*()   

  1. 北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081
  • 收稿日期:2023-10-10 出版日期:2024-04-18 发布日期:2024-04-10
  • 通讯作者: 路瑞芳,孟焕新 E-mail:kqrflu@bjmu.edu.cn;kqhxmeng@bjmu.edu.cn
  • 基金资助:
    国家自然科学基金(82071116)

Relationship between short-chain fatty acids in the gingival crevicular fluid and periodontitis of stage Ⅲ or Ⅳ

Yuru HU,Juan LIU,Wenjing LI,Yibing ZHAO,Qiqiang LI,Ruifang LU*(),Huanxin MENG*()   

  1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2023-10-10 Online:2024-04-18 Published:2024-04-10
  • Contact: Ruifang LU,Huanxin MENG E-mail:kqrflu@bjmu.edu.cn;kqhxmeng@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundations of China(82071116)

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摘要：

目的: 分析Ⅲ期或Ⅳ期牙周炎患者龈沟液(gingival crevicular fluid，GCF)中甲酸、丙酸和丁酸的浓度及其与牙周炎的关系。方法: 选择2008年2月至2011年5月于北京大学口腔医院牙周科就诊的37例全身健康的牙周炎患者作为病例组，选择同期19例全身及牙周健康志愿者作为对照组。每位研究对象每象限选一颗磨牙或切牙的颊侧近中位点采集龈沟液，并记录菌斑指数(plaque index，PLI)、探诊深度(probing depth，PD)、出血指数(bleeding index，BI)和附着丧失(attachment loss，AL)。分离上清液采用高效毛细管电泳技术检测甲酸、丙酸和丁酸的浓度，分析其对牙周炎患病风险的预测能力，以及与牙周炎分级的相关性。结果: 病例组37例牙周炎患者按分期32例为Ⅲ期和5例为Ⅳ期，按分级9名为B级和28名为C级。病例组患者的临床指标均显著高于对照组(P＜0.001)，龈沟液中甲酸含量明显低于对照组[5.37(3.39，8.49) mmol/L vs. 12.29(8.35，16.57) mmol/L，P＜0.001]，而丙酸和丁酸浓度均显著高于对照组[10.23(4.28，14.90) mmol/L vs. 2.71(0.00，4.25) mmol/L，P＜0.001；2.63(0.47，3.81) mmol/L vs. 0.00(0.00，0.24) mmol/L，P＜0.001]。B级和C级牙周炎龈沟液中甲酸、丙酸和丁酸的浓度差异无统计学意义(P＞0.05)。而深袋内丙酸和丁酸的浓度明显高于浅袋，甲酸浓度随袋深的增加反而减少。丙酸(OR=1.51，95%CI：1.29~1.75)和丁酸(OR=3.72，95%CI：1.93~7.17)是牙周炎的危险因素，而甲酸(OR=0.87，95%CI：0.81~0.93)则可能是牙周炎的保护因素。丙酸(AUC=0.852，95%CI：0.805~0.900)、丁酸(AUC=0.889，95%CI：0.841~0.937)、甲酸浓度的倒数(AUC=0.844，95%CI：0.793~0.895)对牙周炎的患病风险具有良好的预测能力。结论: 牙周炎患者龈沟液中甲酸浓度低于对照组，是牙周炎的保护因素，甲酸浓度的倒数对牙周炎患病风险具有良好预测效能；而丙酸和丁酸浓度则升高，是疾病的危险因素，对牙周炎患病风险均具有良好预测价值；三种有机酸浓度随探诊深度而变化，但与牙周炎的分级无明显相关性。

关键词: 牙周炎, 短链脂肪酸, 龈沟液, 分级, 分期

Abstract:

Objective: To analyze the concentration of formic acid, propionic acid and butyric acid in gingival crevicular fluid (GCF) of patients with stages Ⅲ and Ⅳ periodontitis, and their relationship with periodontitis. Methods: The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology, Peking University School and Hospital of Stomatology from February 2008 to May 2011. Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant. Periodontal clinical parameters, including plaque index(PLI), probing depth(PD), bleeding index(BI), and attachment loss(AL). Concentrations of formic acid, propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capillary electrophoresis (HPCE). The prediction ability of formic acid, propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed. Results: In this study, 32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled, including 9 patients with grade B and 28 patients with grade C. Clinical periodontal variables in the patients with periodontitis were significantly higher than those in the control group (P<0.001). Formic acid was significantly lower in periodontitis than that in the control group [5.37 (3.39, 8.49) mmol/L vs. 12.29 (8.35, 16.57) mmol/L, P<0.001]. Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group: Propionic acid, 10.23 (4.28, 14.90) mmol/L vs. 2.71 (0.00, 4.25) mmol/L, P < 0.001; butyric acid, 2.63 (0.47, 3.81) mmol/L vs. 0.00 (0.00, 0.24) mmol/L, P<0.001. There was no significant difference in formic acid, propionic acid and butyric acid concentrations between grade B and grade C periodontitis (P>0.05). Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket, while the concentration of formic acid decreased with the increase of PD. Propionic acid (OR=1.51, 95%CI: 1.29-1.75) and butyric acid (OR=3.72, 95%CI: 1.93-7.17) were risk factors for periodontitis, while formic acid (OR=0.87, 95%CI: 0.81-0.93) might be a protective factor for periodontitis. Propionic acid (AUC=0.852, 95%CI: 0.805－0.900), butyric acid (AUC=0.889, 95%CI: 0.841－0.937), f (formic acid, AUC=0.844, 95%CI: 0.793－0.895) demonstrated a good predictive capacity for the risk of periodontitis. Conclusion: The concentration of formic acid decrease in the GCF of periodontitis patients, which is a protective factor for periodontitis, its reciprocal have good predictive capacity. However, propionic acid and butyric acid increase, which are risk factors for periodontitis and have good predictive capacity. The concentration of formic acid, propionic acid, and butyric acid vary with probing depth, but there is no significant difference between grade B and grade C periodontitis.

Key words: Periodontitis, Short-chain fatty acids, Gingival crevicular fluid, Grade, Stage

中图分类号: 

  • R781.42

表1

研究对象的一般情况"

Variables Control group (n=19) Periodontitis group (n=37) P Grade B (n=9) Grade C (n=28) P
Age/years, M(P25, P75) 23.00 (23.00, 26.00) 34.00 (24.50, 48.00) 0.006 50.00 (48.00, 60.00) 26.00 (22.25, 46.00) <0.001
Gender, Male/Female 10/9 17/20 0.635 5/4 12/16 0.703

表2

龈沟液有机酸浓度比较"

Variables Control group (n=76) Periodontitis group (n=148) P Grade B (n=36) Grade C (n=112) P
Clinical index, $\bar x \pm s$
  PLI 0.92 ± 0.56 2.22 ± 0.64* <0.001 2.22±0.59 2.22±0.65 0.994
  BI 0.74 ± 0.64 3.55 ± 0.66* <0.001 3.58±0.69 3.54±0.66 0.762
  PD/mm 2.04 ± 0.76 6.29 ± 1.72* <0.001 5.36±1.01 6.59±1.79# <0.001
  AL/mm 0.00 ± 0.00 4.72 ± 2.08* <0.001 2.97±1.08 5.28±2.02# <0.001
SCFAs concentrations /(mmol /L), M(P25, P75)
  FOR 12.29 (8.35, 16.57) 5.37 (3.39，8.49)* <0.001 4.38 (2.57, 8.00) 5.50 (3.62, 8.67) 0.175
  PRO 2.71 (0.00, 4.25) 10.23 (4.28，14.90)* <0.001 5.79 (4.19, 15.00) 10.72 (4.38, 14.86) 0.460
  BUTY 0.00 (0.00, 0.24) 2.63 (0.47，3.81)* <0.001 2.86 (1.89, 3.89) 2.43 (0.95, 3.81) 0.129

图1

不同探诊深度分组间的有机酸浓度比较"

图2

有机酸浓度预测牙周炎的ROC曲线"

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ISSN 1671-167X
CN 11-4691/R
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