ASSESSMENT OF METABOLIC AND HUMORAL BLOOD FACTORS IN PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS ASSOCIATED METABOLIC SYNDROME

Abstract

In numerous studies, the authors showed the relationship of pathologies of tissues and organs of the oral cavity with somatic diseases, especially the impact of systemic disorders characteristic of the metabolic syndrome. So, among patients with metabolic disorders (metabolic syndrome, diabetes, systemic lupus erythematosus) inflammatory diseases of the periodontal complex are common. Periodontium, its structures are sensitive to the pathogenic effect of factors that form the proatherogenic spectrum of metabolic disorders. The commonality of inflammation and proatherogenic metabolic disorders from a pathophysiological point of view is quite natural, since both syndromes form the same cells: endothelial and smooth muscle, fibroblasts, monocytes and macrophages, neutrophils, and to a lesser extent platelets, T and B lymphocytes. Also, in both situations, activated neutrophils and tissue macrophages in the “respiratory explosion” reaction enhance the formation of superoxide radicals and activate peroxidation of proteins and lipids, causing alteration of normal tissues. In this regard, the research objective is to evaluate changes in indicators of carbohydrate, lipid metabolism and humoral immunity factors in blood plasma in patients with moderate generalized periodontitis (CGP) combined with metabolic syndrome. Object and methods. 58 patients with chronic generalized periodontitis of moderate severity between the ages of 35 and 63 years (experimental group -OG), mainly against the background of a metabolic syndrome with a central type of obesity, as well as 14 volunteers (practically healthy people) with an intact periodontium aged 25–35 years that made up the control group (CG). All underwent a comprehensive examination. The hygiene index was determined according to Green – Vermillion (I964), РМА, PI according to A. Russel (1967), IR according to Muchlemann (1971), orthopantomography and targeted intraoral images were performed. Glucose was determined in capillary blood on a biochemical analyzer using HUMAN standard kits; C-peptide – enzyme immunoassay with reagents of the company BioChemMak. The level of low density lipoproteins (LDL) was calculated by the difference between the concentration of total cholesterol (OH) and LDL by the formulas. The state of general immunity was assessed by the number of T- and B-lymphocytes, the content of IgA, IgG, IgM in peripheral venous blood using an ROSH enzyme-linked immunosorbent analyzer. Statistical analysis using t-student test. Results and discussion. As a result of studies in patients with MS combined with inflammation in periodontal tissues against the background of hyperinsulinemia and dyslipidemia, pronounced changes in the indices of cellular and humoral immunity were established. Against the background of MS in patients with CGP, an increase in IgG was observed: 1876.0 ± 9.61 mg/dl (control 1156,0 ± 0.18 mg/dl) (p <0.05), the amount of which always rises in the chronic form of inflammation. The amount of IgA – was 98.7 ± 7.31 mg/dl (control 150.8 ± 9.14 mg/dl) (p <0.05). There were no significant changes in the dynamics of IgM concentration in the blood. Against the background of a decrease in IgA, which, apparently, is due to increased synthesis of secretory IgA.

Keywords

• chronic generalized periodontitis
• metabolic syndrome
• systemic and local immunity