2型糖尿病伴牙周炎患者血清RANKL和骨保护素水平的检测及意义

目的:探讨慢性牙周炎伴2型糖尿病患者血清RANKL和骨保护素(OPG)浓度变化与牙槽骨破坏的关系.方法:检查和分析健康组、牙周炎组、2型糖尿病组以及2型糖尿病佯牙周炎组患者血清RANKL和OPG的浓度、空腹血糖水平及牙周检查指数.结果:与健康组相比,牙周炎组OPG显著降低,RANKL略增高,RANKL/OPG比值增高(P＜0.05);糖尿病组OPG明显增高,RANKL几无变化,RANKL/OPG比值降低(P＜0.05);糖尿病伴牙周炎组OPG明显增高,RANKL略增高,RANKL/OPG比值降低;与牙周炎组相比,糖尿病组和糖尿病伴牙周炎组OPG明显增高,RANKL/OPG比值降低(P＜0.05);空腹血糖与临床附着丧失,OPG浓度呈正相关,与RANKL/OPG比值呈负相关(P＜0.05).结论:糖尿病和牙周炎引起RANKL/OPG比值呈现不同的变化,提示糖尿病与牙周炎骨破坏机制可能不同,糖尿病患者与牙周病患者OPG浓度变化提示糖尿病患者的骨吸收可能还有未知的破骨机制.

Changes of Serum RANKL and Osteoprotegerin Levels and Their Significance in Diabetes Mellitus with Periodontitis

Objective: To measure the serum levels of RANKL and osteoprotegerin(OPG) in patients of diabetes mellitus with or without periodontitis,and to explore the relationship between alveolar bone destruction and RANKL/OPG concentration.Methods: The levels of serum RANKL and OPG were compared among health(H),periodontitis(P),diabetes mellitus(DM) and DM+P groups including blood test and periodontal examination.Results: In periodontitis group,OPG was significantly lower,RANKL was slightly increased,RANKL/OPG ratio was higher(P<0.05);in diabetes group,OPG was significantly higher(P<0.05),RANKL had almost no change,and RANKL/OPG ratio was decreased(P<0.05);in diabetes with periodontitis group,both RANKL and OPG were increased(P<0.05),but the ratio was reduced(P<0.05).In diabetes group and diabetes with periodontitis group,OPG was significantly higher(P<0.05),RANKL/OPG ratio was decreased compared to periodontitis group(P<0.05);fasting blood glucose was positively correlated to attachment loss and OPG levels(P<0.05),and negatively correlated to RANKL/OPG ratio.Conclusion: The cause of diabetes and periodontitis in the change of RANKL/OPG ratio was different;the changes of RANKL and OPG concentrations in diabetes and periodontal patients suggest unknown bone resorption mechanism.