唾液中白细胞介素-17和发育内皮细胞区-1（Del-1）在有无2型糖尿病的牙周炎患者中的评价

牙周炎与2型糖尿病（T2DM）之间存在双向正相关关系，白细胞介素17（IL-17）和发育内皮细胞区-1（Del-1）被认为在牙周炎和T2DM中起一定作用。本研究旨在通过检测唾液中IL-17和Del-1水平，探讨牙周炎伴或不伴T2DM患者的相关性。共招募80名参与者，依据牙周与糖尿病检查结果分为健康组（H，n=27）、牙周炎组（P，n=29）和伴糖尿病的牙周炎组（PDM，n=24）。记录牙周参数（菌斑指数[PI]、探诊出血[BOP]、探诊深度[PD]和临床附着丧失[CAL]）及糖尿病参数（空腹血糖[FG]、糖化血红蛋白[HbA1c]），采集静止唾液。通过酶联免疫吸附试验（ELISA）测定唾液中的IL-1β、活性基质金属蛋白酶-8（aMMP-8）、肿瘤坏死因子-α（TNF-α）、IL-6、IL-8、IL-17和Del-1，并分析其与牙周和糖尿病参数的关系。结果显示，牙周炎组和伴糖尿病的牙周炎组的IL-17水平显著高于健康组，Del-1水平显著低于健康组，伴糖尿病的牙周炎组的IL-17水平高于单纯牙周炎组。相关分析显示，唾液中IL-17与Del-1与PD（r=0.36，-0.39，p<0.01）、CAL（r=0.40，-0.42，p<0.01）和BOP（r=0.35，-0.37，p<0.01）均有显著相关性，且与FG（r=0.26，-0.25，p<0.05）及HbA1c（r=0.28，-0.40，p<0.05）相关。IL-17与IL-1β及aMMP-8之间呈正相关（r=0.80，0.77，p<0.01），Del-1则与IL-1β和aMMP-8呈负相关（r=0.59，0.69，p<0.01）。IL-17与Del-1之间呈显著负相关（r=-0.71，p<0.01）。不同年龄组中，老年组的唾液Del-1水平低于年轻组（在健康、牙周炎和伴糖尿病组中），但差异无统计学意义（p>0.05）。牙周炎伴糖尿病患者的唾液IL-17和Del-1水平显著高于单纯牙周炎患者，且两者之间呈逆相关，均与牙周和糖尿病参数（PD、CAL、BOP、FG、HbA1c）相关。牙周炎和2型糖尿病为全球常见疾病，某些炎症介质（IL-17和Del-1）调节中性粒细胞的产生、募集和清除，且被认为参与牙周炎和糖尿病的发生发展。本研究中，健康受试者、牙周炎患者及伴糖尿病患者均表现出IL-17水平升高和Del-1水平降低，伴糖尿病患者的IL-17水平更高，Del-1水平更低，且两者均与牙科检查和血糖水平呈相关关系，显示出逆相关性。

Bidirectional positive relationship between periodontitis and type 2 diabetes mellitus (T2DM) has been recognized, interleukin 17 (IL-17) and developmental endothelial locus-1 (Del-1) are proposed to play roles in periodontitis and T2DM. This study aims to investigate the association of IL-17 and Del-1 in patients with periodontitis with and without T2DM by measuring their salivary levels.A total of 80 participants were enrolled in a cross-sectional study and divided into healthy (H, n = 27), periodontitis (P, n = 29) and periodontitis with diabetes (PDM, n = 24) groups based on their periodontal and diabetic examination results. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment level [CAL]) as well as diabetic parameters (fasting plasma glucose [FG] and glycated hemoglobin [HbA1c]) were documented and unstimulated saliva was collected. Salivary IL-1β, active-matrix metalloproteinase-8 (aMMP-8), tumor necrosis factor-α (TNF-α), IL-6, IL-8, IL-17, and Del-1 were determined through enzyme-linked immunosorbent assay (ELISA) and their relationships with periodontal and diabetic parameters were examined.The periodontitis and periodontitis with diabetes groups showed significantly higher levels of IL-17 and lower levels of Del-1 compared with healthy group. The periodontitis with diabetes group exhibited higher levels of IL-17 and lower levels of Del-1 compared with the periodontitis group. After correlation analysis, there were significant correlations between salivary IL-17 and Del-1 and clinical parameters, IL-17 and Del-1 were correlated with PD (r = 0.36, -0.39, p < 0.01), CAL (r = 0.40, -0.42, p < 0.01) and BOP (r = 0.35, -0.37, p < 0.01), they were correlated with FG (r = 0.26, -0.25, p < 0.05) and HbA1c (r = 0.28, -0.40, p < 0.05). Positive relationships were observed between IL-17 and IL-1β and between IL-17 and aMMP-8 (r = 0.80, 0.77, p < 0.01), while Del-1 exhibited negative correlations with IL-1β and aMMP-8 (r = 0.59, 0.69 p < 0.01). Comparison between IL-17 and Del-1 confirmed an inverse relationship (r = -0.71, p < 0.01). Salivary Del-1 levels in the older group were lower compared with young group across the H, P and PDM groups, although these differences were not statistically significant (p > 0.05).Salivary IL-17 and Del-1 levels in the periodontitis with diabetes group showed significant changes compared with the periodontitis group, they exhibited an inverse relationship and were both correlated with periodontal parameters (PD, CAL, and BOP) and diabetic parameters (FG and HbA1c).Periodontitis and type 2 diabetes mellitus (T2DM) are two common diseases all over the world, some inflammatory mediators (interleukin 17 [IL-17] and developmental endothelial locus-1 [Del-1]) regulate neutrophil production, recruitment and clearance when the body becomes infected and believed to be involved in the progress of diseases of periodontitis and diabetes. In this study, we enrolled healthy subjects, patients with periodontitis, patients with periodontitis and diabetes. We performed dental examinations and evaluated their blood glucose levels, collected their saliva, and detected IL-17 and Del-1 levels in their saliva. We found both patients with periodontitis and patients with periodontitis and diabetes showed higher IL-17 levels and lower Del-1 levels compared with healthy subjects. Patients with periodontitis and diabetes showed higher IL-17 levels and lower Del-1 levels compared with patients with periodontitis. Salivary IL-17 and Del-1 levels were both correlated with dental examination results and blood glucose levels, and salivary IL-17 and Del-1 displayed an inverse relationship.