Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus: Randomized clinical trial
Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus: Randomized clinical trial
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DOI：
10.1002/jper.19-0613
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发表时间：
2020-06-21
影响因子：
4.3
通讯作者：
Santamaria, Mauro P.
中科院分区：
文献类型：
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作者：
Castro dos Santos, Nidia C.;Andere, Naira M. R. B.;Santamaria, Mauro P.
补充omega-3多不饱和脂肪酸（omega-3 PUFA）和低剂量阿司匹林（ASA）已被提出作为控制慢性炎症性疾病的宿主调节方案。本研究的目的是研究口服omega-3 PUFA和ASA作为牙周清创辅助治疗2型糖尿病患者牙周炎的临床和免疫学影响。方法75例患者（n = 25/组）随机分为牙周清创（CG）组、牙周清创后omega-3 PUFA + ASA （3 g鱼油/d + 100 mg ASA/d，持续2个月）组（实验组[TG]1）、牙周清创前omega-3 PUFA + ASA （3 g鱼油/d + 100 mg ASA/d，持续2个月）组（TG2）。在基线（t0）、牙周清创和omega-3 PUFA + ASA或安慰剂后3个月（TG1和CG）、omega-3 PUFA + ASA（牙周清创前）后（t1）和牙周清创后6个月（t2）收集牙周参数和GCF（所有组）。采用多重ELISA法检测GCF细胞因子水平。结果TG1组10例（40%）和TG2组9例（36%）患者达到了治疗的临床终点（小于或等于4个探探深度>= 5 mm），而CG组4例（16%）患者达到了治疗终点。在中度和重度TG1患者中存在临床依恋增加。两个试验组的ifn - γ和白细胞介素(IL)-8水平均随时间下降。TG1组IL-6水平较低。糖化血红蛋白水平因TG1而降低。结论牙周清创后辅助omega-3和ASA治疗2型糖尿病患者牙周炎具有临床和免疫学上的益处。
Background Supplementation with omega-3 polyunsaturated fatty acids (omega-3 PUFA) and low-dose aspirin (ASA) have been proposed as a host modulation regimen to control chronic inflammatory diseases. The aim of this study was to investigate the clinical and immunological impact of orally administered omega-3 PUFA and ASA as adjuncts to periodontal debridement for the treatment of periodontitis in patients type 2 diabetes. Methods Seventy-five patients (n = 25/group) were randomly assigned to receive placebo and periodontal debridement (CG), omega-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months)afterperiodontal debridement (test group [TG]1), or omega-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months)beforeperiodontal debridement (TG2). Periodontal parameters and GCF were collected at baseline (t0), 3 months after periodontal debridement and omega-3 PUFA + ASA or placebo for TG1 and CG (t1), after omega-3 PUFA + ASA (before periodontal debridement) for TG2 (t1), and 6 months after periodontal debridement (all groups) (t2). GCF was analyzed for cytokine levels by multiplex ELISA. Results Ten patients (40%) in TG1 and nine patients (36%) in TG2 achieved the clinical endpoint for treatment (less than or equal to four sites with probing depth >= 5 mm), as opposed to four (16%) in CG. There was clinical attachment gain in moderate and deep pockets for TG1. IFN-gamma and interleukin (IL)-8 levels decreased over time for both test groups. IL-6 levels were lower for TG1. HbA1c levels reduced for TG1. Conclusion Adjunctive omega-3 and ASA after periodontal debridement provides clinical and immunological benefits to the treatment of periodontitis in patients with type 2 diabetes.