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Hu M, Wang Y, Xu W, Bai J, Tang X. The impact of serum uric acid on psoriasis: NHANES 2005-2014 and Mendelian randomization. Front Genet 2024; 15:1334781. [PMID: 38784041 PMCID: PMC11111913 DOI: 10.3389/fgene.2024.1334781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Background Psoriasis is a chronic systemic inflammatory disease, and hyperuricemia is a common comorbidity in patients with psoriasis. However, the exact relationship between uric acid levels and psoriasis remains unclear. This study aimed to explore the association between uric acid levels and psoriasis. Methods Observational study participant data (≥16 years, n = 23,489) from NHANES 2003-2014. We conducted analyses using a weighted multiple logistic regression model. Genetic data sets for uric acid levels and psoriasis were obtained from the IEU database. We selected genetically independent loci closely associated with serum uric acid levels as instrumental variables and performed Mendelian randomization analyses using five complementary methods: inverse variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. Results After adjusting for other covariates, the results revealed no significant association between serum uric acid levels and psoriasis (b = 0.999, 95% CI: 0.998, 1.001, p = 0.275). Subgroup analyses stratified by gender and ethnicity showed no significant association between sUA and psoriasis in any of the subgroups. Furthermore, the MR analysis involved the selection of 227 SNPs that were associated with both sUA and psoriasis. IVW results demonstrated no causal relationship between sUA and psoriasis (OR = 0.282, 95% CI: -0.094-0.657, p = 0.142). Conclusion Our study suggests that uric acid levels are not significantly causally related to psoriasis. This finding provides valuable insights for the treatment and prevention of psoriasis, indicating that merely reducing uric acid levels may not be an effective strategy to reduce the risk of psoriasis onset.
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Affiliation(s)
- Minghui Hu
- Department of Orthopedics, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Yangyang Wang
- Department of Internal Medicine, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Wenwu Xu
- Department of Orthopedics, Dongguan Tungwah Hospital, Dongguan, Guangdong, China
| | - Juan Bai
- Department of Orthopedics, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Xingming Tang
- Department of Internal Medicine, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
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Xu J, Jia Y, Mao Z, Wei X, Qiu T, Hu M. Association between serum uric acid, hyperuricemia and periodontitis: a cross-sectional study using NHANES data. BMC Oral Health 2023; 23:610. [PMID: 37644435 PMCID: PMC10466695 DOI: 10.1186/s12903-023-03320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Diabetes and other metabolic diseases have been linked to the development of periodontitis, but little research has been done to determine whether serum uric acid (SUA) levels and hyperuricemia play a role. This study aimed to investigate the relationship between SUA, hyperuricemia, and periodontitis. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, we created a nationally representative data set. We used multivariable logistic regression models to assess the relationship between SUA, hyperuricemia, and periodontitis and presented odds ratios (OR) in women and men, respectively. RESULTS In women, adjusted multivariable regression models showed that SUA (4.1-4.3mg/dl) was associated with higher odds of periodontitis (OR = 1.43; 95% confidence interval (CI):1.0 ~ 2.03, p = 0.047) with SUA (≤ 3.3mg/dl) as reference. The risk of periodontitis tended to increase slightly but insignificantly with increasing SUA levels, and the adverse effects occurred only when SUA increased to a certain level, and then reached a plateau. In men, the adjusted OR values for SUA (4.9-5.2mg/dl), SUA (5.3-5.5mg/dl), SUA (5.9-6.2mg/dl), and SUA (6.3-6.5mg/dl) were 0.66 (95% CI: 0.45 ~ 0.96, p = 0.029), 0.58 (95% CI: 0.40 ~ 0.85, p = 0.006), 0.67(95% CI: 0.47 ~ 0.97, p = 0.035), and 0.67 (95% CI: 0.45 ~ 0.99, p = 0.043), respectively, with SUA (≤ 4.3mg/dl) as reference. The elevated SUA levels are protective against periodontitis, but there is a range within which the risk of periodontitis decreases, followed by a non-significant tendency to increase. CONCLUSIONS The levels of SUA that are linked to the risk of periodontitis. Future prospective longitudinal studies and strategies are required to further confirm whether controlled SUA treatment is an effective adjunct to systematic periodontal therapy and whether SUA can be used as a diagnostic biomarker to assess the risk or progression of periodontitis.
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Affiliation(s)
- Jing Xu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Yifan Jia
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Zhi Mao
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Xiaoxi Wei
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Tianyuan Qiu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Min Hu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China.
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Joo JY, Park HR, Cho Y, Noh Y, Lee CH, Lee SG. Increased prevalence of periodontitis with hypouricemic status: findings from the Korean National Health and Nutrition Examination Survey, 2016-2018. J Periodontal Implant Sci 2023; 53:283-294. [PMID: 36731863 PMCID: PMC10465814 DOI: 10.5051/jpis.2202220111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/06/2022] [Accepted: 11/08/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the relationship between serum uric acid (SUA) levels and the risk of periodontitis in Korean adults using data from the Korean National Health and Nutrition Examination Survey (KNHANES). METHODS This cross-sectional study used data from the KNHANES 2016-2018 and analysed 12,735 Korean adults aged ≥19 years who underwent oral examinations. Hypouricemia was defined as SUA <3 mg/dL in men and <2 mg/dL in women, and hyperuricemia was defined as SUA ≥7 mg/dL in men and ≥6 mg/dL in women. RESULTS The weighted prevalence of hypouricemia and hyperuricemia was 0.6% and 12.9%, respectively. The overall weighted periodontitis rate was 30.5%. The frequency of periodontitis in subjects with hypouricemia, normouricemia, and hyperuricemia were 51.1%, 30.3%, and 30.6%, respectively. Study participants with hypouricemia were significantly older, had significantly fasting blood glucose levels, and had better kidney function than non-hypouricemic participants. In univariate logistic regression analyses, hypouricemia was associated with periodontitis, but hyperuricemia was not. The fully adjusted model revealed that the adjusted odds ratio of hypouricemia for periodontitis was 1.62 (95% confidence interval, 1.13-2.33), while the relationship between hyperuricemia and periodontitis in the multivariable logistic regression model was not significant. CONCLUSIONS The results of this study suggest that hypouricemia is associated with an increased risk of periodontitis.
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Affiliation(s)
- Ji-Young Joo
- Department of Periodontology, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
- Periodontal Disease Signaling Network Research Center, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Korea
| | - Hae Ryoun Park
- Periodontal Disease Signaling Network Research Center, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Korea
- Department of Oral Pathology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Youngseuk Cho
- Department of Statistics, Pusan National University College of Natural Sciences, Busan, Korea
| | - Yunhwan Noh
- Department of Statistics, Pusan National University College of Natural Sciences, Busan, Korea
| | - Chang Hun Lee
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Seung-Geun Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Pusan National University Hospital, Busan, Korea.
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Ye LW, Zhao L, Mei ZS, Zhou YH, Yu T. Association between periodontitis and uric acid levels in blood and oral fluids: a systematic review and meta-analysis. BMC Oral Health 2023; 23:178. [PMID: 36973692 PMCID: PMC10045947 DOI: 10.1186/s12903-023-02900-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Uric acid, a formerly-known antioxidant that has recently been linked to numerous inflammatory diseases as a pro-inflammatory and -oxidative mediator in pathological conditions. It is imperative to reassess the association between periodontitis and uric acid locally and systematically. The aim of this systematic review was to systemically evaluate the association between periodontitis and the uric acid (UA) levels in blood, saliva and gingival crevicular fluid (GCF). METHODS Relevant clinical studies up to January 28, 2023 were identified and retrieved from electronic databases including PubMed, Scopus, EMBASE and Web of Science, with periodontitis, uric acid, hyperuricemia and gout as the keywords. The weighted (WMD) or standardized mean difference (SMD) was calculated using fixed- or random-effect models. Methodological heterogeneity was assessed. RESULTS Sixteen eligible observational studies and one RCT were enrolled, which included 1354 patients with periodontitis and 989 controls. Three sample types for UA detection were involved, including blood (n = 8), saliva (n = 9) and GCF (n = 1). Meta-analysis demonstrated an enhanced plasma UA concentration (WMD = 1.00 mg/dL, 95% CI 0.63 to 1.37, P < 0.001) but a decreased salivary UA level (SMD = -0.95, 95% CI -1.23 to -0.68, P < 0.001) in periodontitis versus control. Statistical heterogeneity among the plasma- and saliva-tested studies were moderate (I2 = 58.3%, P = 0.066) and low (I2 = 33.8%, P = 0.196), respectively. CONCLUSIONS Within the limitations of the enrolled studies, it seems that there is an association between periodontitis and increased blood UA and decreased salivary UA. (Registration no. CRD42020172535 in Prospero).
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Affiliation(s)
- Lu-Wen Ye
- Department of Periodontics, The Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, No.195 Dongfeng Road West, Guangzhou, 510182, China
| | - Li Zhao
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510056, China
| | - Ze-Song Mei
- Department of Periodontics, The Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, No.195 Dongfeng Road West, Guangzhou, 510182, China
| | - Ying-Hong Zhou
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, 4006, Australia
| | - Ting Yu
- Department of Periodontics, The Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, No.195 Dongfeng Road West, Guangzhou, 510182, China.
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Su X, Jin K, Zhou X, Zhang Z, Zhang C, Li Y, Yang M, Huang X, Xu S, Wei Q, Cheng X, Yang L, Qiu S. The association between sex hormones and periodontitis among American adults: A cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1125819. [PMID: 36864844 PMCID: PMC9971556 DOI: 10.3389/fendo.2023.1125819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION After adulthood, as a person grows older, the secretion of sex hormones in the body gradually decreases, and the risk of periodontitis increases. But the relationship between sex hormones and periodontitis is still controversial. METHODS We investigated the association between sex hormones and periodontitis among Americans over 30 years old. 4,877 participants containing 3,222 males and 1,655 postmenopausal females who had had periodontal examination and detailed available sex hormone levels, were included in our analysis from the 2009-2014 National Health and Nutrition Examination Surveys cycles. We applied multivariate linear regression models to estimate the connection between sex hormones and periodontitis after converting sex hormones into categorical variables through tertile. Additionally, to ensure the stability of the analysis results, we carried out a trend test, subgroup analysis, and interaction test. RESULTS After fully adjusting the covariates, estradiol levels were not associated with periodontitis in both males and females with a P for trend = 0.064 and 0.064, respectively. For males, we found that sex hormone-binding globulin was positively associated with periodontitis (tertile3 vs tertile1: OR=1.63, 95% CI=1.17-2.28, p = 0.004, P for trend = 0.005). Congruously, free testosterone (tertile3 vs tertile1: OR=0.60, 95% CI=0.43-0.84, p = 0.003), bioavailable testosterone (tertile3 vs tertile1: OR=0.51, 95% CI=0.36-0.71, p < 0.001), and free androgen index (tertile3 vs tertile1: OR=0.53, 95% CI=0.37-0.75, p < 0.001) was found to be negatively associated with periodontitis. Moreover, subgroup analysis of age found a closer relationship between sex hormones and periodontitis in those younger than 50 years. CONCLUSION Our research suggested that males with lower bioavailable testosterone levels affected by sex hormone-binding globulin were at a higher risk of periodontitis. Meanwhile, estradiol levels were not associated with periodontitis in postmenopausal women.
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Affiliation(s)
- Xingyang Su
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Kun Jin
- Department of Urology, the First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xianghong Zhou
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Zilong Zhang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Chichen Zhang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Yifan Li
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Mi Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xinyi Huang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shishi Xu
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Xu Cheng
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Lu Yang, ; Shi Qiu,
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- Center of Biomedical big data, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Lu Yang, ; Shi Qiu,
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Uppin R, Varghese S. Estimation of serum, salivary, and gingival crevicular uric acid of individuals with and without periodontal disease: A systematic review and meta-analysis. J Int Soc Prev Community Dent 2022; 12:393-403. [PMID: 36312583 PMCID: PMC9615931 DOI: 10.4103/jispcd.jispcd_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/25/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Uric acid (UA) levels in serum, salivary, and gingival crevicular fluid (GCF) may be associated with periodontal diseases. Hence, this study aimed to estimate the UA concentration in serum, saliva, and GCF of periodontal disease and non-periodontal disease subjects by conducting a systematic review and a meta-analysis of the reported studies. Materials and Methods: A review of the available literature was searched in the electronic databases of PubMed, Cochrane, Science Direct, and EBSCO for the relevant publications. All the related case–control, cross-sectional, and cohort studies reporting the UA levels in the blood, salivary, and GCF between periodontal disease patients and healthy controls were analyzed. Significant heterogeneity was observed in the studies. Hence, a continuous random-effects model was used. The findings are described in forest plots with the point estimations and 95% confidence interval (CI). A value of P less than 5% was considered as a significant heterogeneity test. Results: Of the initial 166 study titles screened, 14 reported papers were eligible for quantitative review. The subgroup analysis of serum UA revealed a mean difference of 0.299 (95% CI: 0.029–0.569, I2=85.64%, P<0.001), indicating an increase in the UA levels in periodontal disease. However, the subgroup analysis by salivary UA demonstrated a mean difference of −0.783 (95% CI: −1.577–0.011, I2= 94.62%, P<0.001), suggesting a lower side of the UA level in periodontal diseases. The subgroup analysis based on case–control studies showed a mean difference of 0.004 (95% CI: −0.286–0.294, I2=84.99%, P<0.001), indicating no changes in UA levels in periodontal disease. On the contrary, cohort studies and cross-sectional studies showed a mean difference : 95% CI: −1.016, −3.272–1.241, I2=97.84%, P<0.001 and 95%: −1.230, −4.410–1.949, I2=97.7%, P<0.001, indicating reduction in UA levels in periodontal disease cases. Conclusion: The current review suggests an increase in the serum UA levels in periodontal disease than in healthy controls. Contrarily, the salivary UA levels decreased in periodontal disease patients. It is unknown why UA levels are opposite in the blood and saliva of periodontal disease patients requiring further explanation.
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Chen ZY, Xu TT, Liang ZJ, Zhao L, Xiong XQ, Xie KK, Yu WX, Zeng XW, Gao J, Zhou YH, Luo G, Yu T. Untargeted and targeted gingival metabolome in rodents reveal metabolic links between high-fat diet-induced obesity and periodontitis. J Clin Periodontol 2021; 48:1137-1148. [PMID: 33998036 DOI: 10.1111/jcpe.13486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 12/19/2022]
Abstract
AIM To characterize gingival metabolome in high-fat diet (HFD)-induced obesity in mice with/without periodontitis. METHODS HFD-induced obesity mouse model was established by 16-week feeding, and a lean control group was fed with low-fat diet (n = 21/group). Both models were induced for periodontitis on the left sides by molar ligation for 10 days, whereas the right sides were used as controls. Gingival metabolome and arginine metabolism were analysed by non-targeted/targeted liquid chromatography-mass spectrometry. RESULTS Of 2247 reference features, presence of periodontitis altered 165 in lean versus 885 in HFD mice; and HFD altered 525 in absence versus 1435 in presence of periodontitis. Compared with healthy condition, periodontitis and HFD had distinct effects on gingival metabolome. Metabolomic impacts of periodontitis were generally greater in HFD mice versus lean controls. K-medoids clustering showed that HFD amplified the impacts of periodontitis on gingival metabolome in both intensity and extensity. Ten metabolic pathways were enriched, including 2 specific to periodontitis, 5 specific to HFD and 3 shared ones. Targeted validation on arginine metabolism confirmed the additive effects between HFD and periodontitis. CONCLUSION The obese population consuming excessive HFD display amplified metabolic response to periodontitis, presenting a metabolic susceptibility to exacerbated periodontal destruction.
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Affiliation(s)
- Zi-Yun Chen
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tian-Tian Xu
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhao-Jia Liang
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Li Zhao
- Department of Prosthodontics, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Qin Xiong
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kun-Ke Xie
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wan-Xin Yu
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiao-Wen Zeng
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jie Gao
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ying-Hong Zhou
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Queensland University of Technology, Centre for Biomedical Technologies, Queensland, Australia
| | - Gang Luo
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ting Yu
- Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis. ACTA ACUST UNITED AC 2021; 57:medicina57050493. [PMID: 34068221 PMCID: PMC8153122 DOI: 10.3390/medicina57050493] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 12/23/2022]
Abstract
The objective of this article was to conduct a systematic review of the literature to contrast the existing evidence regarding the relationship between periodontal disease (PD) and diabetes mellitus (DM) with the possibly increased risk of SARS-CoV-2 infection, as well as to establish a hypothesis that explains the ways in which this interaction could take place. A literature search up from 1 January 2020 to 21 March 2021 was conducted in three electronic databases, namely, PubMed, Web of Science, and Scopus, in order to identify studies on periodontal disease alone or in conjunction with diabetes mellitus, reporting any relation with SARS-CoV-2 infection as a primary outcome. Only articles published in the English language were included. Due to the lack of studies, we decided to collect all the theoretical and clinical evidence suggesting a possible biological pathway evidencing the relationship among PD, DM, and SARS-CoV-2 infection. From a total of 29 articles, 12 were included for final review studies (five reviews, two hypotheses, one Special Issue, one perspective, one commentary, one case–control study, and one case report). In addition, this systematic review article hypothesizes the correlation between PD and type 2 diabetes mellitus (T2DM) by expression of angiotensin-converting enzyme 2 (ACE2) in periodontal tissue and the risk of SARS-CoV-2 infection. T2DM is a metabolic disorder characterized by high blood glucose levels resulting from altered insulin secretion or action. Likewise, periodontitis and T2DM are inflammatory disorders with a bidirectional association, and both diseases have a similar immunomodulatory cascade and cytokine profile. ACE2 is a crucial component of the renin–angiotensin system (RAS) and the key factor of entry in the cells by the new SARS-CoV-2. ACE2 is widely distributed in the lung and kidneys, and interestingly has a great distribution in the oral cavity, principally in the tongue and periodontal tissue. ACE2 in periodontal tissue plays a crucial role between health and disease. Moreover, the ACE2/Ang-(1-7)/MasR axis is downregulated in the dysbiotic and inflammatory periodontal environment. Nevertheless, the balance of ACE2 activity is modified in the context of concurrent diabetes, increasing the expression of ACE2 by the uncontrolled glycemia chronic in T2DM. Therefore, the uncontrolled hyperglycemia possibly increases the risk of developing periodontitis and triggering overexpression of ACE2 in periodontal tissue of T2DM patients, with these events potentially being essential to SARS-CoV-2 infection and the development of mild-to-severe form of COVID-19. In this sense, we would like to point out that the need for randomized controlled trials is imperative to support this association.
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Yang Y, Zhang JL, Zhou Q. Targets and mechanisms of dietary anthocyanins to combat hyperglycemia and hyperuricemia: a comprehensive review. Crit Rev Food Sci Nutr 2020; 62:1119-1143. [PMID: 33078617 DOI: 10.1080/10408398.2020.1835819] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hyperglycemia and hyperuricemia are both metabolic disorders related to excessive amount of metabolites in blood, which are considered as high risk factors for the development of many chronic diseases. Enzymes, cells, tissues and organs, which are relevant to metabolism and excretion of glucose and UA, are usually regarded to be the targets in treatment of hyperglycemia and hyperuricemia. Several drugs have been commonly applied to combat hyperglycemia and hyperuricemia through various targets but with unignorable side effects. Anthocyanins have become promising alternatives against hyperglycemia and hyperuricemia because of their bio-activities with little side effects. Structurally different anthocyanins from berry fruits, cherries and purple sweet potato lead to the diverse functional activity and property. This review is aimed to illustrate the specific targets that are available for anthocyanins from berry fruits, cherries and purple sweet potato in hyperglycemia and hyperuricemia management, as well as discuss the structure-activity relationship, and the underlying mechanisms associated with intracellular signaling pathway, anti-oxidative stress and anti-inflammation. In addition, the relationship of hyperglycemia and hyperuricemia, and the possibly regulative role of anthocyanins against them, along with the effects of anthocyanins in clinical trial are mentioned.
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Affiliation(s)
- Yang Yang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Jiu-Liang Zhang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China.,Ministry of Education, Key Laboratory of Environment Correlative Dietology, Wuhan, China
| | - Qing Zhou
- Department of Pharmacy, Wuhan City Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Analyzing the Association between Hyperuricemia and Periodontitis: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134777. [PMID: 32630802 PMCID: PMC7370102 DOI: 10.3390/ijerph17134777] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/18/2020] [Accepted: 06/27/2020] [Indexed: 01/05/2023]
Abstract
Hyperuricemia arises from the buildup of excessive uric acid in the blood, and it is implicated in the development of periodontitis. The objective of this study was to investigate the association between hyperuricemia and periodontitis using a cross-sectional study design and Korean Genome and Epidemiology Study Health Examinee (KoGES HEXA) data. This prospective cohort study used epidemiological data from the KoGES from 2004 to 2016. Among 173,209 participants, 8809 with hyperuricemia and 126,465 controls (non-hyperuricemia) were selected. This study defined hyperuricemia as >7.0 mg/dL of uric acid in men and >6.0 mg/dL in women. This study analyzed the history of periodontitis among hyperuricemia and control participants. Participants’ age, gender, income, obesity, smoking, alcohol consumption, and nutritional intake were all examined. Chi-square tests, independent t-tests, and two-tailed analyses were used for statistical analysis. The adjusted OR (aOR) of hyperuricemia for periodontitis was 0.89 (95% confidence interval (CI) = 0.81–0.96, p = 0.005). This study demonstrated that hyperuricemia was associated with periodontitis. This finding meant that elevated uric acid levels could have a positive effect on periodontitis. However, further studies should be performed to determine the range of uric acid levels beneficial to periodontal health.
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