慢性牙周炎对OLETF大鼠肾脏功能的影响

目的：研究慢性牙周炎对2型糖尿病（type 2 diabetes mellitus，T2DM）大鼠肾脏功能的影响。方法选用4周龄雄性自发性T2DM OLETF大鼠30只，同种系同周龄糖耐量正常LETO大鼠（L组）20只作为实验对象。36周龄时，将到达糖耐量受损期26只OLETF大鼠（O组），按照是否复合慢性牙周炎模型随机分为糖尿病合并慢性牙周炎组[O CP（+）组]和糖尿病组[O CP（-）组]；LETO大鼠也随机分为慢性牙周炎组[L CP（+）组]和正常组[L CP（-）组]。O CP（+）组和L CP（+）组采取丝线结扎联合涂菌建立慢性牙周炎模型，建模20周后处死所有大鼠，收集血清，全自动生化分析仪检测反映肾脏功能的生化指标，包括血清白蛋白、总蛋白、尿素和肌酐4个指标。结果血清白蛋白（t=11.131，P=0.002）、总蛋白水平（t=21.696，P<0.001）O组显著低于L组，O CP（+）组白蛋白（t=2.155，P=0.049）、总蛋白水平（t=2.554，P=0.023）也较O CP（-）组显著下降，而L CP（+）组与L CP（-）组比较差异均无统计学意义。血清肌酐水平O组显著高于L组（t=9.099，P=0.005），O CP（+）组也明显高于O CP （-）组（t=4.443，P<0.001），而L CP（+）组与L CP（-）组比较，差异无统计学意义。血清尿素水平O组比L组显著升高（t=5.684，P=0.024），而O CP（+）组与O CP（-）组比较（t=1.484，P=0.160）、L CP（+）组与L CP（-）组比较（t=0.075，P=0.932）差异无统计学意义。结论慢性牙周炎未对正常大鼠肾脏功能产生明显影响；但在T2DM大鼠肾脏已有损害的情况下，慢性牙周炎恶化了肾脏功能，并且T2DM和牙周炎在肾脏病变发生中有交互、协同作用。     

慢性牙周炎合并糖尿病患者唾液及龈下菌斑中牙周致病菌检测临床研究

目的    探讨慢性牙周炎（CP）合并2型糖尿病（T2DM）患者与单纯CP患者唾液及龈下菌斑中牙周致病菌的差异性。方法    选择河南大学第一附属医院口腔科2012年8月至2015年9月伴T2DM的CP患者40例为CP+T2DM组,同时选取背景相似的慢性CP患者65例为CP组,并选取健康体检者35名作为对照组,采用聚合酶链反应（PCR）检测各组受试者唾液及龈下菌斑中牙龈卟啉单胞菌（Pg）、放线共生放线杆菌（Aa）、具核梭杆菌（Fn）、福塞坦菌（Tf）、中间型普里沃菌（Pi）、齿垢密螺旋体（Td）等可疑致病菌种类和相对含量。结果    3组受试者唾液及龈下菌斑中Pg、Aa和Tf检出率比较差异有统计学意义（P＜0.05）,而Fn、Pi和Td检出率差异无统计学意义（P＞0.05）,3组受试者唾液及龈下菌斑中Fn检出率均最高,CP+T2DM组唾液及龈下菌斑中Pg、Aa、Tf检出率均显著高于对照组和CP组（P＜0.05）,而CP组仅Pg检出率显著高于对照组（P＜0.05）,CP+T2DM组和CP组唾液及龈下菌斑中Pg、Aa和Tf相对含量均显著高于对照组（P＜0.05）,且CP+T2DM组唾液及龈下菌斑中Aa和Tf相对含量显著高于CP组,差异有统计学意义（P＜0.05）。结论    CP患者和伴糖尿病的CP患者牙周可疑致病菌的种类和数量存在明显差异,CP+T2DM组患者Pg、Aa和Tf检出率更高,可能与糖尿病关系更为密切。     

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目的探讨牙周基础治疗对2型糖尿病（T2DM）伴慢性牙周炎患者血清炎性细胞因子及糖化血红蛋白（HbAlc）含量的影响。方法选择2012年3月至2013年9月就诊于沈阳市口腔医院牙周科患者135例,其中T2DM伴慢性牙周炎患者63例（T2DM组）,单纯慢性牙周炎患者72例（CP组）;另从沈阳市口腔医院体检中心选择牙周健康正常人50名,作为正常对照组。于牙周基础治疗前及治疗后3个月,检查各组的牙周状况以及检测血清炎性细胞因子和HbAlc含量,并对检测结果进行比较分析。结果牙周基础治疗能改善慢性牙周炎患者的牙周健康状况,降低炎性细胞因子水平。牙周基础治疗前T2DM组和CP组的C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）及白细胞介素-6（IL-6）含量均高于正常对照组,差异有统计学意义（均P〈0.05）。与牙周基础治疗前比较,T2DM组和CP组的CRP、TNF-α及IL-6含量在牙周基础治疗后3个月均明显下降,差异有统计学意义（均P〈0.05）。牙周基础治疗前,T2DM组的HbAlc含量明显高于CP组和正常对照组;牙周基础治疗后3个月,T2DM组的HbAlc含量显著下降,且其治疗前后差异有统计学意义（P〈0.05）。结论 T2DM伴慢性牙周炎患者进行牙周基础治疗,可改善患者的牙周状况和全身健康状况,从而减少糖尿病及其并发症的发生和发展。     

基于AGEs的糖尿病在牙周病发展过程的影响机制研究

目的:考察糖尿病(T2DM)与牙周病(CP)发病之间的相关性,并探讨其可能的作用机制.方法:60只SD大鼠随机分为4组,每组15只,分别构建T2DM、CP、T2DM合并CP大鼠模型和一组正常对照,4周、8周后,测量大鼠实验区牙周探诊深度和菌斑指数,并用ELISA检测血清中IL-6,TNF-α及AGEs表达水平情况.结果...     

二甲双胍潜在用途研究进展

二甲双胍（metformin,MF）是双胍类降糖药物,主要用于治疗II型糖尿病（Type 2 diabetes mellitus, T2DM）和代谢综合征。然而,二甲双胍的实际和潜在的用途已经远远超出了其规定的使用范围。近年来随着对二甲双胍研究的越来越多,该药物在不同情况下的更多作用相继被发现。二甲双胍除了有降低血糖的作用以外还有抗肿瘤作用、抗衰老作用、抗炎作用、菌群改善作用和潜在的成骨作用。本文就二甲双胍在各领域的作用作一综述,为临床和研究人员提供参考。     

老年糖尿病患者根管治疗的临床观察

目的：观察老年糖尿病（diabetes mellitus,DM）患者根管预备术后疼痛情况及根管治疗远期疗效。方法：选择300例需做根管治疗的老年患者,观察150例DM患者与150例非DM患者根管预备术后疼痛情况及二年后疗效。结果：根管预备术后,牙髓炎组,DM患者与非DM患者疼痛无显著性差异（P〉0.05）,根尖周炎组,DM患者术后疼痛发生率较非DM患者高;根管治疗后二年疗效,DM患者与非DM患者无显著性差异（P〉0.05）。结论：患牙髓炎或根尖周炎的老年DM患者经过完善的根管治疗亦可获得良好的治疗效果。     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg),伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa),具核梭杆菌(Fusobacterium nucleatum,Fn),中间普氏菌(Prevotella intermedia,Pi),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.     

龈沟液β-防御素-2、β-防御素-3在慢性牙周炎与2型糖尿病中的水平研究

目的通过检测龈沟液中β-防御素2、β-防御素3的表达水平,探讨其在慢性牙周病与2型糖尿病中的可能作用。方法选取慢性牙周炎伴2型糖尿病组(T2DMCP组)20例,2型糖尿病组(T2DM组)20例,慢性牙周炎组(CP组)20例,健康组(H组)20例作。采用酶联免疫吸附试验(ELISA)检测龈沟液中β-防御素-2和β-防御素-3水平。比较组间龈沟液中β-防御素-2和β-防御素-3水平的差异性,分析β-防御素-2和β-防御素-3之间的相关性与β-防御素-2和β-防御素-3与牙周指标的相关性。结果 CP组、T2DM组、T2DMCP组的临床指标PD、CAL、BI和GCF量均高于H组(P<0.05)。T2DMCP组的PD、CAL、BI和GCF量均高于T2DM组和CP组(P<0.05)。龈沟液中β-防御素-2,β-防御素-3水平在H组高于CP组、T2DM组和T2DMCP组(P<0.05),CP组和T2DM组高于T2DMCP组(P<0.05)。龈沟液中β-防御素-2水平与β-防御素-3水平呈正相关(P<0.05)。结论慢性牙周炎和2型糖尿病可降低龈沟液β-防御素-2和β-防御素-3的水平,提示β-防御素-2、β-防御素-3对牙周组织起保护作用。     

Diabetes mellitus-associated periodontitis: differences between type 1 and type 2 diabetes mellitus

Aspriello SD, Zizzi A, Tirabassi G, Buldreghini E, Biscotti T, Faloia E, Stramazzotti D, Boscaro M, Piemontese M. Diabetes mellitus‐associated periodontitis: differences between type 1 and type 2 diabetes mellitus. J Periodont Res 2011; 46: 164–169. © 2010 John Wiley & Sons A/S Background and Objective: Although many studies have appeared about diabetes mellitus‐associated periodontitis, few have compared periodontitis inflammatory markers between type 1 (T1DM) and type 2 diabetes mellitus (T2DM), and information regarding this issue is scarce and contradictory. We evaluated the levels of plasma C‐reactive protein and of interleukin‐1β (IL‐1β), interleukin‐6 (IL‐6) and tumour necrosis factor‐α (TNF‐α) in gingival crevicular fluid in two groups of subjects affected by T1DM and T2DM, in order to identify possible differences between the two classes in the inflammatory mechanisms of diabetes mellitus‐associated periodontitis. Material and Methods: Plasma C‐reactive protein and gingival crevicular fluidIL‐1β, IL‐6 and TNF‐α were measured in periodontitis patients affected by type 1 (P‐T1DM, n = 24) and type 2 diabetes mellitus (P‐T2DM, n = 24). Results: Gingival crevicular fluid levels of IL‐1β and TNF‐α in P‐T1DM subjects were significantly higher than in P‐T2DM subjects. In P‐T1DM subjects, we found significant negative correlations between the duration of diabetes mellitus and IL‐1β and between the duration of diabetes mellitus and TNF‐α. Conclusion: This study shows that IL‐1β and TNF‐α levels in periodontitis patients with T1DM are affected by the duration of diabetes mellitus.     

Expression of Leptin and Visfatin in Gingival Tissues of Chronic Periodontitis With and Without Type 2 Diabetes Mellitus: A Study Using Enzyme‐Linked Immunosorbent Assay and Real‐Time Polymerase Chain Reaction

Background: The aim of this study is to investigate the protein and gene expression of leptin and visfatin in gingival tissue from patients with chronic periodontitis (CP), patients with CP and type 2 diabetes mellitus (T2DM), and healthy individuals. Methods: The study includes 50 individuals: 10 healthy individuals, 20 patients with CP, and 20 patients with CP and T2DM. Plaque index, gingival index, probing depth, and clinical attachment loss were measured, and gingival biopsies were obtained. Leptin and visfatin protein expression in gingival tissues was determined using enzyme‐linked immunosorbent assay, and messenger RNA (mRNA) expression was measured via real‐time polymerase chain reaction. Results: The highest leptin mRNA and protein expression was observed in the control group and was significantly (P ≤0.05) different from the CP and CP+T2DM groups. Gingival tissues from patients with CP and T2DM had a significant increase in visfatin and a decrease in leptin gene and protein expression (P <0.05) compared with both controls and patients with CP. Conclusion: Expression of leptin and visfatin in the gingival tissues suggests a possible role for these adipokines in the pathogenesis of CP and T2DM.     

Ⅱ型糖尿病合并牙周炎患者龈下菌斑微生物群落分析

目的：本研究旨在比较Ⅱ型糖尿病合并慢性牙周炎患者与无糖尿病的牙周炎患者龈下菌斑微生物构成。方法：12名患者分为糖尿病合并慢性牙周炎组（T2DM＋CP组）与慢性牙周炎组（CP组）2组,各6人。记录所有患者基本信息及牙周临床参数,包括年龄、性别、探诊深度和附着丧失。根据探诊深度和附着丧失取患病位点的菌斑样本。PCR检测7种牙周可疑致病菌。采用DGGE分离扩增的16SrDNA片段。结果：两组结果显示两组牙周参数无显著差异。两组7种细菌检出率相似。所有对象中均检出牙龈卟啉单胞菌、福塞坦氏菌、齿垢密螺旋体和中间普氏菌,而具核梭杆菌在两组中均有一个样本未检出。变黑普氏菌在T2DM＋CP组的2个样本中检出,而CP组有4个样本检出。伴放线共聚菌在所有样本中均未检测到。DGGE分析结果示两组间条带数量及树状聚类分析均无显著差异。结论：Ⅱ型糖尿病合并牙周炎患者龈下菌斑的牙周可疑致病菌的检出情况以及DGGE分析与无糖尿病患者相似。     

Routine Prophylaxes Every 3 Months Improves Chronic Periodontitis Status in Type 2 Diabetes

Background: Periodontitis and type 2 diabetes mellitus (T2DM) are major health problems, especially in low‐income populations with little access to dental care. Low‐cost models for treatment of periodontal disease have not been tested in controlled studies in low‐income populations. Dental prophylaxis, which includes removal of supragingival calculus and plaque, has been shown to arrest the progression of periodontitis. A controlled clinical trial was conducted to determine the effect of dental prophylaxis on periodontitis in T2DM. Methods: Twenty‐six patients with T2DM and chronic periodontitis (CP) and 26 without T2DM with CP were selected. Periodontal probing depth (PD), gingival bleeding on probing (BOP), clinical attachment level (CAL), and surfaces with plaque were recorded at baseline and 3, 6, and 9 months after initial treatment. All the participants received instructions on oral hygiene and one session of dental prophylaxis at baseline and every 3 months. Glycated hemoglobin (HbA1c) levels were measured at baseline and every 3 months in patients with T2DM. Results: A significant improvement of PD, BOP, and sites with plaque was observed 3 months after treatment in patients with T2DM (P = 0.001). In controls, mean PD significantly improved after 6 months compared with baseline (P = 0.001). No significant improvement of CAL occurred in either group. No significant differences in periodontal parameters between the groups were detected, and no participant showed progression of CP during the 9‐month study period. Dental prophylaxis did not influence HbA1c levels, and no association among HbA1c concentration, pretreatment metabolic status, and severity of CP was found. Conclusion: Routine prophylaxes every 3 months significantly improve periodontal health and prevent progression of CP in both poorly controlled and well‐controlled patients with T2DM.     

The KCNQ1 gene polymorphism as a shared genetic risk for rheumatoid arthritis and chronic periodontitis in Japanese adults: A pilot case‐control study

1 Background

A number of studies have suggested a bidirectional relationship of periodontitis with rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM). However, the genetic factors that underlie these relationships have not been elucidated.

2 Methods

We conducted a multicenter case‐control study that included 185 patients with RA and chronic periodontitis (CP), 149 patients with T2DM and CP, 251 patients with CP, and 130 systemically and periodontally healthy controls from a cohort of Japanese adults to assess the shared genetic risk factors for RA and CP as well as for T2DM and CP. A total of 17 candidate single nucleotide polymorphisms (SNPs) associated with RA, T2DM, and CP were genotyped.

3 Results

Multiple logistic regression analyses revealed that the KCNQ1 rs2237892 was significantly associated with comorbidity of RA and CP (P = 0.005) after adjustment for age, sex, and smoking status. The carriers of the T allele among patients with RA and CP showed significantly higher disease activity scores including 28 joints using C‐reactive protein values than the non‐carriers (P = 0.02), although the age, female percentage, and smoking status were comparable. Other SNPs were not associated with comorbidity of RA and CP, T2DM and CP, or susceptibility to CP.

4 Conclusion

The results of the present pilot study suggest for the first time that the KCNQ1 rs2237892 may constitute a shared genetic risk factor for RA and CP, but not for T2DM and CP in Japanese adults.     

Association among interleukin-6 gene polymorphism, diabetes and periodontitis in a Chinese population

Objectives:  Diabetics significantly increase risk for periodontitis. Interleukin-6 (IL-6) gene polymorphism may play certain roles in the progression of periodontitis with diabetes. The purpose of this study was to assess the association among IL-6 gene polymorphisms, type 2 diabetes mellitus (T2DM) and chronic periodontitis (CP) in a Chinese population.
Material and methods:  DNA was obtained from 159 patients with CP, 88 patients with T2DM, 110 patients with CP&T2DM and 135 control subjects. The -174/-572/-597 polymorphisms of IL-6 gene were investigated by restriction fragment length polymorphism of polymerase chain reaction products. The results were further confirmed by sequencing. Significance was set at P  < 0.008 after Bonferroni correction.
Results:  Among four groups, CP&T2DM group showed the lowest IL-6-572 CC genotype and C-allele frequencies (54.5% and 74.1%). In this regard, there were significant differences between CP&T2DM group and the control group [ P  = 0.006, odds ratio (OR)  =  0.475, 95% CI: 0.279–0.808 and P  = 0.002, OR = 0.502, 95% CI: 0.319–0.788 respectively]. Logistic regression with adjustment for age, gender, body mass index, smoking and stress showed no significant difference in terms of IL-6-572 genotypes ( P  = 0.058, OR= 0.523, 95% CI: 0.268–1.022).
Conclusions:  The IL-6-572 genotype and allele distributions are unique to subjects with CP&T2DM in a Chinese population.     

Hyperglucose Contributes to Periodontitis: Involvement of the NLRP3 Pathway by Engaging the Innate Immunity of Oral Gingival Epithelium

Background: The NLRP3 inflammasome is essentially a family of intracellular innate immune sensors that can respond to bacterial challenge and initiate early host immunity responses. However, the involvement and possible molecular mechanism of the NLRP3 pathway in the context of chronic periodontitis (CP) and diabetes mellitus have yet to be fully elucidated. Methods: Gingival tissues were collected from patients with CP and/or type 2 diabetes mellitus (T2DM), and the expression of NLRP3 and interleukin (IL)‐1β was analyzed by immunohistochemistry. To explore the possible molecular mechanism, human gingival epithelial cells (HGECs) were established in vitro and challenged with lipopolysaccharide (LPS) and/or high glucose. High extracellular K⁺ was applied as an inhibitor of NLRP3. The NLRP3 pathway was analyzed by immunocytochemistry and quantitative polymerase chain reaction. Results: Compared with control individuals, NLRP3 and IL‐1β were significantly upregulated in oral gingival epithelium of patients with CP and/or T2DM (P <0.05). The expression of NLRP3 was significantly upregulated in HGECs when stimulated in vitro by LPS or high glucose (P = 0.00). The simultaneous stimulation of LPS and high glucose contributed to significant upregulation of NLRP3 expression versus LPS or high glucose alone (P = 0.00). Although expression of caspase 1 and IL‐1β protein were increased in HGECs when stimulated by LPS, they were partially inhibited after the NLRP3 was successfully blocked. Conclusion: For patients with T2DM and CP, hyperglycemic status may exacerbate the inflammation state of gingival tissue by activating the NLRP3 pathway, and this abnormal host inflammatory response may contribute to further tissue breakdown.     

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??Objective    To investigate the differences in detection results of periodontal pathogens in saliva and gingival crevicular fluid between patients with chronic periodontitis??CP?? and those complicated with diabetes mellitus??DM??. Methods    Of the patients treated in the First Affiliated Hospital of Henan University between Aug. 2012 and Sep. 2015??40 cases of patients with CP complicated with T2DM were selected as CP+T2DM group??65 cases of patients with simple CP were selected as CP group??and 35 cases of healthy subjects were selected as the control group. The kinds and relative contents of suspected pathogens??such as Porphyromonas gingivalis??Pg????Actinobacillus actinomycetemcomitans??Aa????Fusobacterium nucleatum??Fn????Tannerella forsythia??Tf????intermediate type Prevotella intermedia??Pi??and Treponema denticola??Td????in saliva and gingival crevicular fluid were detected by polymerase chain reaction??PCR??. Results    The detection rates of Pg??Aa and Tf in the saliva and gingival crevicular fluid showed statistically significant differences among the three groups??P??0.05????but there were no significant differences in the detection rates of Fn??Pi or Td??P??0.05??. The detection rate of Fn in saliva and gingival crevicular fluid of the three groups was the highest??and the detection rates of Pg??Aa and Tf in saliva and gingival crevicular fluid of CP +T2DM group were significantly higher than those in control group and CP group??P??0.05??. The detection rate of Pg in CP group was significantly higher than that in the control group??P??0.05??. The relative contents of Pg??Aa and Tf in the saliva and gingival crevicular fluid of CP+T2DM group and CP group were significantly higher than those in the control group??P??0.05??. The relative contents of Aa and Tf in saliva and gingival crevicular fluid of CP+T2DM group were significantly higher than those in CP group??P??0.05??. Conclusion    There are significant differences in the types and number of suspected pathogens between patients with simple CP and those with CP and DM. Pg??Aa and Tf have more advantages in patients with DM??which may be closely related to DM.