RELATIONSHIP BETWEEN PERIODONTAL DISEASE AND TYPE 2 DIABETES IN GULLAH POP

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 糖尿病患者牙周病的发病率、严重程度和进展情况均有所增加。非裔美国人患糖尿病和牙周病的负担不成比例。 NHANES III人群牙周病的总体患病率为7.3%，非糖尿病非洲裔美国人的患病率最高（11.4%）。 与全国数据相比，J. Fernandes博士研究的2型糖尿病患者中，讲Gullah语的非洲裔美国人的牙周病患病率非常高（70.64%）。 2型糖尿病和牙周病是讲古拉语的非洲裔美国人的公共卫生问题。 在该人群中，较高的糖化血红蛋白A1 c（HbA 1c）与临床附着丧失（CAL）较高的牙齿比例增加相关。 糖尿病明显增加牙周病的风险，但牙周病对糖尿病血糖控制的影响及其发生机制尚不清楚。 牙周疾病可能以类似于肥胖的方式成为胰岛素抵抗的引发者或传播者，从而使血糖控制变得复杂。 基质金属蛋白酶（MMP）是导致组织降解和骨吸收的重要因素。 其中，龈沟液（GCF）中的MMP-8是与牙周炎相关的最突出的胶原酶。与健康患者相比，来自牙周炎患者的未经处理的牙龈组织和GCF的牙龈提取物含有病理性升高水平的催化活性形式（aMMP-8）的胶原酶-2（MMP-8）。GCF的分析可以提供一个有用的非侵入性的手段，以评估和监测牙周组织的病理生理状态，在特定的网站的方式。 本研究项目的目的是测试假设牙周病的治疗与更好的糖尿病血糖控制（HbA 1c）和较低水平的催化活性形式的MMP-8在讲Gullah的非洲裔美国人的患者。 我们将对这一居住在南卡罗来纳州海岸海岛上的遗传混杂最少的人群进行干预性研究。 具体目标1：证明牙周病进展控制不佳的2型糖尿病Gullah患者比控制良好的患者更严重。 具体目标2：评估牙周治疗对Gullah人群血糖控制水平的影响。 具体目标3：评估基线（牙周干预前）和3个月和6个月后MMP-8催化活性形式的浓度。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. It is established that the prevalence, severity and progression of periodontal disease is increased in patients with diabetes. African Americans have a disproportionate burden of diabetes and periodontal disease. The overall prevalence of periodontal disease for NHANES III population was 7.3%, with non-diabetic African Americans exhibiting the highest prevalence (11.4%). As compared to the national figures, the type 2 diabetic Gullah-speaking African American studied by Dr. J. Fernandes had a very high prevalence of periodontal disease (70.64%). Type 2 diabetes mellitus and periodontal disease are public health problems among Gullah-speaking African Americans. In this population higher glycated hemoglobin A1c (HbA1c) is associated with increasing proportion of teeth with higher clinical attachment loss (CAL). Diabetes clearly increases the risk for periodontal diseases, but less clear is the impact of periodontal diseases on glycemic control of diabetes and the mechanisms through which this occurs. It is possible that periodontal diseases may serve as initiators or propagators of insulin resistance in a way similar to obesity, thereby complicating glycemic control. Matrix metalloproteinases (MMPs) are responsible for tissue degradation and bone resoption. Of these, MMP-8 in gingival crevicular fluid (GCF) is the most prominent collagenase associated with periodontitis. In contrast to healthy patients, gingival extracts of untreated gingival tissue and GCF from periodontitis patients contain pathologically elevated levels of collagenase-2 (MMP-8) in the catalytically active form (aMMP-8). Analysis of GCF could provide a useful noninvasive means to assess and monitor the pathophysiological status of the periodontium tissue in a site-specific manner. The purpose of this research project is to test the hypothesis that treatment of periodontal disease is associated with better diabetes glycemic control (HbA1c) and lower levels of the catalytically active form of MMP-8 in the Gullah-speaking African American patients. We will conduct an interventional study on this population with minimal genetic admixture, living on the Sea Islands of the South Carolina coast. Specific Aim 1: To demonstrate that periodontal disease progression on poorly controlled Type 2 diabetic Gullah patients is more severe than on well-controlled patients. Specific Aim 2: To assess the effects of periodontal therapy on the level of glycemic control in the Gullah population. Specific Aim 3: To assess the concentration of the catalytically active form of MMP-8 at baseline (prior to periodontal intervention) and 3 and 6 months later.