围绝经期妇女在接受或不接受牙周病刮治术中孕酮的“双刃剑”作用。
The "double-edged" role of progesterone in periodontitis among perimenopausal women undergoing or not undergoing scaling and root planing.
发表日期：2023
作者：
Shengjie Yan, Ying Man, Jun Lu, Liyun Cui, Feifei Niu, Jianyong Qin
来源：
Frontiers in Endocrinology
摘要：
孕酮（PG）是一种重要的性类固醇激素，常用于保护围绝经期妇女的子宫内膜。本研究旨在探讨围绝经期妇女中牙周炎对PG的不同反应，这些妇女是否接受了洗牙和根面计划术（SRP）。共纳入129例患有轻至中度牙周炎的围绝经期妇女，并按照以下治疗方案进行治疗：SRP组（n = 35）；SRP + PG组（n = 34）；PG组（n = 31）；以及无治疗组（n = 29）。使用牙周探针测量袋深（PPD）、临床附着水平（CAL）、龈沟出血指数（SBI）和探诊出血（BOP）。使用ELISA技术测量牙槽隙液（GCF）中的C-反应蛋白（CRP）、白细胞介素（IL）-6和肿瘤坏死因子-α（TNF-α）等3种炎症指标的水平。在接受SRP的围绝经期妇女中，PPD、CAL、SBI、BOP和GCF中的炎症因子水平均明显下降。未接受SRP的患者经过6个月的PG治疗后，PPD、SBI、BOP和GCF中的CRP、IL-6和TNF-α水平显著升高。相反，PG在接受SRP的患者中对牙周炎的抑制作用显著，具体表现为明显降低的BOP和IL-6，并稍微下降的SBI、CRP和TNF-α。PG诱导的变化在停药后6个月（12个月时）消失。在患有牙周炎的围绝经期妇女中，PG在无SRP的情况下增强了牙周炎的炎症反应，但对接受了SRP的患者的牙周炎炎症产生了抑制作用。版权所有 © 2023 Yan, Man, Lu, Cui, Niu and Qin.
Progesterone (PG) is an important sex steroid hormone commonly administered to protect the endometrium in perimenopausal women. The present study aimed to explore differential responses of periodontitis to PG in perimenopausal women who did or did not undergo scaling and root planing (SRP).A total of 129 perimenopausal women with mild-to-moderate periodontitis were enrolled and underwent treatment as follows: SRP (n = 35); SRP + PG (n = 34); PG (n = 31); and no treatment (s) (n = 29). Pocket probing depth (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and bleeding on probing (BOP) were measured using periodontal probes. Three inflammatory markers, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) were measured using ELISA techniques.PPD, CAL, SBI, BOP, and levels of inflammatory factors in GCF were all significantly decreased in perimenopausal women with periodontitis after SRP. In patients who did not undergo SRP, 6 months of PG treatment significantly elevated PPD, SBI, BOP, and GCF levels of CRP, IL-6, and TNF-α. In contrast, PG exhibited inhibitory effects on periodontal inflammation in patients who underwent SRP, evidenced by significantly decreased BOP and IL-6, and slightly decreased SBI, CRP, and TNF-α. PG-induced changes dissipated 6 months after withdrawal of PG (at 12 months).Among perimenopausal women with periodontitis, PG enhanced periodontal inflammation in the absence of SRP but inhibited periodontal inflammation in those who underwent SRP.Copyright © 2023 Yan, Man, Lu, Cui, Niu and Qin.