南方医科大学学报 ›› 2017, Vol. 37 ›› Issue (05): 663-.

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牙周基础治疗对肥胖大鼠实验性牙周炎及代谢水平的影响

柴巧学,钟素兰,倪佳,陈蕾,周磊,章锦才   

  • 出版日期:2017-05-20 发布日期:2017-05-20

Beneficial effect of periodontal therapy on insulin resistance and lipid metabolism in obese rats with periodontitis

  • Online:2017-05-20 Published:2017-05-20

摘要: 目的探讨牙周干预治疗肥胖合并牙周炎的大鼠,对大鼠牙周炎的控制、胰岛素抵抗及脂代谢水平的影响。方法将SD大 鼠随机分为正常组(C组)、肥胖组(O组)、牙周炎合并肥胖组(P组)和牙周治疗组(T组)。P组和T组大鼠行上颌第2磨牙牙周结 扎,T组大鼠做基础牙周治疗,所有大鼠24周龄处死。眼眶静脉取血检测血脂四项,胰岛素和血糖,计算胰岛素抵抗(HOMA稳 态模型胰岛素抵抗值,HOMA-IR)。取大鼠颌骨及各脏器行病理观察;实时定量PCR法检测肝脏中胰岛素受体底物-1(IRS-1), 胰岛素受体底物-2(IRS-2)的表达。结果P组与单纯肥胖O组比较:HOMA-IR、LDL-C值均出现升高;而IRS-1、IRS-2表达及 HDL-C值则低于肥胖组。T组与P组比较,大鼠的胰岛素抵抗HOMA-IR值下降(P<0.05);IRS-1及IRS-2的mRNA表达均有增 高(P<0.05),TG值变化不明显(P>0.05),HDL-C升高,LDL-C及TC值出现下降(P<0.05)。病理学观察:T组大鼠颌骨标本切片 中的炎细胞浸润情况出现好转。P组大鼠颌骨破坏最严重。肝脏切片比较,P组大鼠的肝细胞中肝脂变最为广泛,炎症浸润最 严重。结论牙周的炎症可下调IRS-1,IRS-2的表达,加重肥胖大鼠的胰岛素抵抗和血脂代谢紊乱。牙周治疗对于改善肥胖大 鼠胰岛素抵抗的情况,减轻血脂代谢紊乱有一定的影响。

Abstract: Objective To investigate the effect of periodontal therapy in controlling periodontitis and on insulin resistance and lipid metabolism in obese rats with periodontitis. Methods Sprague-Dawley rats were randomized into normal group (group C), obese group (group O), periodontitis combined with obesity group (group P) and periodontal treatment group (group T). The obese rats in groups P and T were subjected to ligation of the maxillary second molar with silk thread to induce experimental periodontitis, and the rats in group T received periodontal therapy after the ligation. All the rats were sacrificed at the age of 24 weeks for measurement of blood lipids, insulin and blood glucose levels, and insulin resistance index (HOMA-IR) was calculated. The expressions of insulin receptor substrate-1 (IRS-1) and IRS-2 in the liver tissues were detected using real-time quantitative polymerase chain reaction (RT-PCR). Results Compared with the obese rats in group O, the rats in group P showed significantly higher HOMA-IR and LDL-C and lower expressions of IRS-1 and IRS-2 mRNA expression and HDL-C level (P<0.05). Compared with those in group P, the mRNA expressions of IRS-1 and IRS-2 and HDL-C level were significantly increased and LDL-C level, TC level and HOMA-IR were all decreased in group T (P<0.05), but the level of TG was comparable between the two groups. Pathological examination revealed lessened inflammatory cell infiltration and tissue destruction in the upper jaw of the rats in group T; the rats in group P presented with the most obvious upper jaw destruction and steatosis and inflammatory cell infiltration in the liver. Conclusion Periodontal inflammation can downregulate the expression of IRS-1 and IRS-2 and increase insulin resistance and dyslipidemia in obese rats. Periodontal therapy produces a beneficial effect in improving insulin resistance and reducing dyslipidemia in obese rats.