关键词:

2型糖尿病, 慢性牙周炎, Th1/Th2, 肿瘤坏死因子α, 疾病严重程度, 相关性

Abstract:

Objective　To explore the correlation of Th1/Th2 and tumor necrosis factor alpha (TNF-α) levels with the severity of chronic periodontitis (CP) in patients with type 2 diabetes mellitus (T2DM). Methods　This retrospective analysis included 90 patients with T2DM and CP (a T2DM+CP group), 60 patients with CP (a CP group), and 60 healthy examinees (a control group) from Yulin Traditional Chinese Medicine Hospital between January and December 2023. There were 48 males and 42 females in the T2DM+CP group; they were (52.35±5.78) years old; their disease course was (3.44±0.91) years. There were 33 males and 27 females in the CP group; they were (52.63±5.69) years old; their disease course was (3.56±1.07) years. There were 31 males and 29 females in the control group; they were (52.58±5.64) years old. The patients with T2DM and CP were categorized into a mild group (33 cases), a moderate group (30 cases), and a severe group (27 cases) based on the periodontal assessment standards. Their general data were collected. The periodontal indicators [probing depth (PD), attachment loss (AL), gingival index (GI), and plaque index (PLI)], inflammatory markers [interferon gamma (INF-γ), interleukin 4 (IL-4), and tumor necrosis factor alpha (TNF-α)], and Th1/Th2 cell ratios were compared. The Spearman's correlation analysis was employed to assess the correlation of Th1/Th2 and TNF-α with the severity of periodontitis in the T2DM+CP group. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic values of Th1/Th2 and TNF-α for CP + T2DM. t, F, and χ² tests were applied. Results　There were no statistical differences in gender, age, body mass index, and CP course between the three groups (all P>0.05). The levels of INF-γ in the CP+T2DM group and the CP group were lower than that in the control group [(29.25±8.46) μg/L and (51.45±16.25) μg/L vs. (90.13±29.85) μg/L]; the PD, AL, GI, PLI, levels of IL-4 and TNF-α, and Th1/Th2 ratios in the CP+T2DM group and the CP group were higher than those in the control group [(6.38±1.23) mm and (4.82±0.64) mm vs. (1.93±0.52) mm, (5.79±0.82) mm and (3.02±1.06) mm vs. (0.42±0.11) mm, (1.63±0.25) and (1.13±0.18) vs. (0.52±0.14), (1.25±0.14) and (1.04±0.12) vs. (0.73±0.05), (25.84±3.72) μg/L and (20.04±5.18) μg/L vs. (14.38±2.16) μg/L, (67.88±22.22)μg/L and (56.47±15.03) μg/L vs. (25.17±8.42) μg/L, and (2.28±0.68) and (1.33±0.41) vs. (0.41±0.13)]; there were statistical differences (F=185.595, 423.411, 860.564, 533.540, 367.510, 160.486, 112.925, and 253.712; all P<0.05). The Th1/Th2 ratio and TNF-α level in the mild group, the moderate group, and the severe group were (1.47±0.21), (2.61±0.34), and (2.89±0.26) and (46.82±5.93) μg/L, (63.73±7.32) μg/L, and (98.24±6.89) μg/L, with statistical differences (F=233.226 and 436.772; both P<0.05). The Spearman's correlation analysis showed that Th1/Th2 and TNF-α were positively correlated wtih the severity of periodontitis (r=0.852 and 0.914; both P<0.05). The areas under the curves (AUC) of Th1/Th2 and TNF-α were 0.866 and 0.631; the sensitivities were 63.3% (57/90) and 57.8% (52/90); the specificities were 98.3% (59/60) and 63.3% (38/60). The AUC of the combination was 0.881; the sensitivity was 73.3% (66/90); the specificity was 88.3% (53/60). Conclusions　In patients with T2DM+CP, Th1/Th2 ratio and TNF-α are significantly positively correlated with the severity of periodontitis. Their combination provides good diagnostic efficacy for the disease.

Key words:

Type 2 diabetes mellitus, Chronic periodontitis, Th1/Th2, Tumor necrosis factor alpha, Disease severity, Correlation