白介素-6在炎症性贫血与慢性牙周炎患者中的相关性研究

Correlation Study of Interleukin-6 in Patients with Anemia of Inflammation and Chronic Periodontitis

摘要: 目的：探究白介素-6及牙周指标在炎症性贫血(anemia of inflammation, AI)与慢性牙周炎(chronic periodontitis, CP)患者中的相关性。方法：收集2023年11月~2024年1月期间就诊于安徽医科大学附属巢湖医院患者(主要为血液内科、口腔科、体检中心)共计142人。AI患者根据慢性牙周炎诊断标准，将其分为AI + CP组，AI组。非AI患者分为CP组，健康对照组(H组)。检查并统计四组牙周情况，指标包括牙石指数(CI)、探诊出血指数(BI)、牙周探诊深度(PD)和附着丧失(AL)。统计比较四组口腔健康影响情况量表14 (OHIP-14)评分和龈沟液(gingival crevicular fluid, GCF) IL-6水平。结果：对四组IL-6水平、OHIP-14评分采用单因素方差分析，差异具有统计学意义(IL-6: F = 279.024; OHIP-14: F = 108.806; P < 0.05)。对四组PD、AL水平采用Kruskal-Wallis检验，差异皆具有统计学意义(PD: H = 113.673; AL: H = 130.302; P < 0.05)。对四组BI、CI水平采用卡方检验，差异皆具有统计学意义(BI: χ² = 44.432, P < 0.05; CI: χ² = 19.434, P = 0.022 < 0.05)。在H组中，GCF IL-6水平与PD、CI水平呈正相关，P < 0.05；在CP组与AI + CP组中，GCF IL-6水平与PD、AL、BI、CI皆呈正相关，P < 0.05；在AI组中，GCF IL-6水平与BI呈正相关，P < 0.05。二元logistic回归模型分析结果显示，较高水平的IL-6、BI、CI、OHIP-14评分是影响CP发生的危险因素。受试者工作特征曲线(Receiver operating characteristic curve, ROC)分析，GCF IL-6诊断AI患者发生CP的最佳截断值为15.45 pg/ml，[曲线下面积(Area under the curve, AUC) (95% Cl) = 0.954 (0.918~0.990), P < 0.001]。GCF IL-6诊断CP患者发生AI的最佳截断值为12.25 pg/ml，[AUC (95% Cl) = 0.980 (0.963~0.997)，P < 0.001]。结论：慢性牙周炎与炎症性贫血之间具有相关性，健康人群需注重口腔卫生特别是牙周状况的维护，GCF有希望作为对于CP、AI新的评估监测辅助手段。GCF IL-6水平对于临床诊断AI与CP具有一定临床意义。

Abstract: Objective: Exploring the correlation between interleukin-6 and periodontal indicators in patients with anemia of inflammation (AI) and chronic periodontitis (CP). Methods: A total of 142 patients from the Hematology Department, Stomatology Department, and Physical Examination Centers of Chaohu Hospital Affiliated to Anhui Medical University (November 2023~January 2024) were enrolled. AI patients were categorized into AI + CP and AI groups based on CP diagnostic criteria, while non-AI patients were divided into CP and healthy control (H) groups. Periodontal parameters including calculus index (CI), bleeding index (BI), probing depth (PD), and attachment loss (AL) were assessed and recorded across the four groups. Statistical comparison of Oral Health Impact Profile-14 (OHIP-14) scores and gingival crevicular fluid (GCF) IL-6 levels across four groups. Results: Significant differences in IL-6 levels and OHIP-14 scores across the four groups were observed using one-way ANOVA (IL-6: F = 279.024; OHIP-14: F = 108.806; P < 0.05). Kruskal-Wallis tests revealed statistically significant differences in probing depth (PD) and attachment loss (AL) across the four groups (PD: H = 113.673; AL: H = 130.302; P < 0.05). Chi-square tests revealed statistically significant differences in bleeding index (BI) and calculus index (CI) across the four groups (BI: χ² = 44.432, P < 0.05; CI: χ² = 19.434, P = 0.022 < 0.05). In the healthy group (H), GCF IL-6 levels showed positive correlations with probing depth (PD) and calculus index (CI) (P < 0.05). In both the chronic periodontitis (CP) and AI + CP groups, GCF IL-6 levels were positively correlated with PD, attachment loss (AL), bleeding index (BI), and CI (P < 0.05); In the anemia of inflammation group (AI), GCF IL-6 levels were positively correlated with bleeding index (BI) (P < 0.05). Binary logistic regression analysis revealed that elevated levels of IL-6, bleeding index (BI), calculus index (CI), and OHIP-14 scores were significant risk factors for the development of chronic periodontitis (CP). Receiver operating characteristic (ROC) curve analysis demonstrated that the optimal cutoff value of GCF IL-6 for diagnosing CP in AI patients was 15.45 pg/ml, with an area under the curve (AUC) of 0.954 (95% CI: 0.918~0.990; P < 0.001) and AI in CP patients was 12.25 pg/ml, with an area under the curve (AUC) of 0.980 (95% CI: 0.963~0.997; P < 0.001) .Conclusion: There exists a correlation between chronic periodontitis and anemia of inflammation. Chronic periodontitis is associated with anemia of inflammation. Maintaining oral hygiene and periodontal health is critical for preventing systemic inflammation. GCF IL-6 shows promise as a biomarker for monitoring CP and AI, offering clinical diagnostic value for these conditions.