A proposed model linking inflammation to obesity, diabetes, and periodontal infections
A proposed model linking inflammation to obesity, diabetes, and periodontal infections
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DOI：
10.1902/jop.2005.76.11-s.2075
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发表时间：
2005-11-01
影响因子：
4.3
通讯作者：
Murayama, Y
中科院分区：
文献类型：
--
作者：
Genco, RJ;Grossi, SG;Murayama, Y
背景：肥胖是糖尿病、心血管疾病和牙周病的重要危险因素。脂肪细胞似乎分泌促炎细胞因子，其可能是连接这些疾病的发病机制的分子。我们评估了肥胖、牙周病和糖尿病胰岛素抵抗以及血浆肿瘤坏死因子α（TNF α）及其可溶性受体水平之间的关系（sTNF α）来评估炎症与肥胖、糖尿病和牙周感染的关系。牙周病，肥胖，在第三次全国健康与营养调查（NHANES III）中检查了胰岛素抵抗。在12，367名非糖尿病受试者中，使用可变体重指数（BMI）评估肥胖，并通过平均临床附着丧失评估牙周疾病。在来自纽约伊利县的1,221名成年人中评估了TNF α和sTNF α的血浆水平，这些成年人代表了BMI的最高和最低四分位数。结果：在研究的NHANES III部分，BMI与牙周附着丧失的严重程度呈正相关（P < 0.001）。加权多元logistic回归显示，这种关系可能是由胰岛素抵抗介导的，因为超重的人（BMI >= 27 kg/m2）与高水平胰岛素抵抗（IR）的比值比为1.48（95%置信区间1.13 - 1.93）严重牙周病相比，超重受试者与低IR。在伊利县成人人口，在BMI最高四分位数的个体中发现TNF α和sTNF α受体的最高水平。TNF α水平与牙周病的正相关，发现只有在那些最低的四分位数的BMI.Conclusions：肥胖是牙周病的一个重要的预测因子，胰岛素抵抗似乎介导这种关系。此外，肥胖与TNF α及其可溶性受体的高血浆水平相关，这反过来可能导致炎症过度状态，增加牙周病的风险，并部分导致胰岛素抵抗。有必要进一步研究胰岛素抵抗的分子基础及其与糖尿病、牙周病和肥胖症的关系，以充分验证脂肪细胞产生促炎细胞因子是肥胖与糖尿病和牙周感染相关的致病因素这一假设。
Background: Obesity is an important risk factor for diabetes, cardiovascular disease, and periodontal disease. Adipocytes appear to secrete proinflammatory cytokines which may be the molecules linking the pathogenesis of these diseases. We evaluated the relationship between obesity, periodontal disease, and diabetes mellitus insulin resistance as well as the plasma levels of tumor necrosis factor alpha (TNFa) and its soluble receptors (sTNF alpha) to assess the relationship of inflammation to obesity, diabetes, and periodontal infections.Methods: The relationship between periodontal disease, obesity, and insulin resistance was examined in the Third National Health and Nutrition Examination Survey (NHANES III). In a population of 12,367 non-diabetic subjects, the variable body mass index (BMI) was used as an assessment of obesity and periodontal disease was assessed by mean clinical attachment loss. The plasma levels of TNF alpha and sTNF alpha were assessed in subsets of 1,221 adults from Erie County, New York, who represented the highest and lowest quartile of BMI. These subjects had extensive periodontal and medical evaluations.Results: In the NHANES III portion of the study, BMI was positively related to severity of periodontal attachment loss (P < 0.001). Weighted multiple logistic regressions showed that this relationship is likely mediated by insulin resistance, since overweight individuals (with BMI >= 27 kg/m(2)) with high levels of insulin resistance (IR) exhibited an odds ratio of 1.48 (95% confidence interval 1.13 - 1.93) for severe periodontal disease as compared to overweight subjects with low IR. In the Erie County adult population, the highest levels of TNFa, and sTNF alpha receptors were found in those individuals in the highest quartile of BMI. A positive correlation of TNF alpha levels with periodontal disease was found only in those in the lowest quartile of BMI.Conclusions: Obesity is a significant predictor of periodontal disease and insulin resistance appears to mediate this relationship. Furthermore, obesity is associated with high plasma levels of TNF alpha and its soluble receptors, which in turn may lead to a hyperinflammatory state increasing the risk for periodontal disease and also accounting in part for insulin resistance. Further studies of the molecular basis of insulin resistance and its relationship to diabetes, periodontal disease, and obesity are necessary to fully test the hypothesis that adipocyte production of proinflammatory cytokines is a pathogenic factor linking obesity to diabetes and periodontal infections.