中国实用口腔科杂志

中国实用口腔科杂志 ›› 2023, Vol. 16 ›› Issue (6): 694-699.DOI: 10.19538/j.kq.2023.06.009

• 论著 • 上一篇    下一篇

冠状动脉粥样硬化患者牙周炎患病情况与外周血胆碱代谢物水平相关性研究

王    艳1，2，周    欣3，黄玲燕1，李    兵1，吴    娟1，杨    洁1，李益民4，解伟格1，谢思静1   

  1. 1. 南京大学医学院附属口腔医院·南京市口腔医院，江苏  南京  210000；2. 淮安市口腔医院，江苏  淮安  223001；3. 苏州口腔医院，江苏  苏州  215000；4. 南京医科大学邵逸夫医院，江苏  南京  210000
  • 出版日期:2023-11-30 发布日期:2023-12-20
  • 基金资助:
    国家自然科学基金（81801041）；南京市卫生科技发展专项资金重点项目（ZKX21055）

  • Online:2023-11-30 Published:2023-12-20

摘要： 目的    研究在冠状动脉粥样硬化患者中牙周炎患病情况与外周血胆碱代谢物水平的相关性。方法    选取2018—2020年于南京市胸科医院确诊的冠状动脉粥样硬化患者66例，经口腔检查后将患者分为牙周炎组（45例）和牙周健康组（21例），比较两组患者基本信息（年龄、体质指数、性别、吸烟状况及外周血血糖、低密度脂蛋白、高密度脂蛋白、甘油三酯、C反应蛋白水平）。采用液相色谱串联质谱法检测患者外周血胆碱代谢物［三甲胺（TMA）、氧化三甲胺（TMAO）、甜菜碱、胆碱、肌酸酐、左旋胆碱］水平，并采用四分位数的有序回归分析冠状动脉粥样硬化患者牙周炎患病情况与胆碱代谢物水平的相关性。结果    两组患者基本信息的比较，差异均无统计学意义（均P > 0.05）； 对两组患者外周血胆碱代谢物的检测发现，牙周炎组外周血TMAO水平［12.97（8.85，18.17）ng/mL］高于牙周健康组［5.81（3.23，10.62）ng/mL］，差异有统计学意义（Z = -3.297，P = 0.001）。四分位数有序回归分析结果显示，冠状动脉粥样硬化患者外周血TMAO水平与牙周炎患病情况存在相关性（95%CI：-2.589 ~ -0.334，P = 0.011）。结论    冠状动脉粥样硬化合并牙周炎的患者外周血TMAO水平升高，提示牙周炎可能通过影响TMA代谢途径促进动脉粥样硬化的发展。

关键词: 氧化三甲胺, 牙周炎, 冠状动脉粥样硬化

Abstract: Objective    To study the correlation between the prevalence of periodontitis and choline metabolite levels in peripheral blood of patients with coronary atherosclerosis. Methods    Totally 66 patients with coronary atherosclerosis  diagnosed in Nanjing Chest Hospital from 2018 to 2020 were selected，and the patients were divided into the periodontitis group （45 patients）and the health group（21 patients）according to the oral examination results. The basic information of the two groups（age，body mass index，gender，smoking status，and peripheral blood glucose，low-density lipoprotein，high-density lipoprotein，triglyceride，and C-reactive protein levels）was compared. The level of peripheral blood choline metabolites ［trimethylamine（TMA），trimethylamine N-oxide（TMAO），betaine，choline，creatinine，L-choline］ was measured by liquid chromatography tandem mass spectrometry. The correlation between the prevalence of periodontitis and the levels of choline metabolites in patients with coronary atherosclerosis was studied via ordered regression analysis for the quartiles. Results    The basic information showed no statistically significant differences between the two groups（P > 0.05）. TMAO levels of peripheral blood in the periodontitis group［12.97（8.85，18.17）ng/mL］was higher than that in the health group［5.81（3.23，10.62）ng/mL］，and the difference was statistically significant（Z = -3.297，P = 0.001）. Ordered regression analysis showed that patients′ periodontal condition was correlated with the peripheral blood TMAO levels（95%CI：-2.589 - -0.334，P = 0.011）. Conclusion    Elevated peripheral blood TMAO level in patients with coronary atherosclerosis combined with periodontitis suggests that periodontitis may promote the development of atherosclerosis by affecting the TMA metabolic pathway.

Key words: trimethylamine N-oxide, periodontitis, coronary atherosclerosis