氧化应激在慢性牙周炎与代谢功能障碍相关脂肪肝病中的潜在作用及机制探讨

doi:10.19439/j.sjos.2026.02.014

摘要/Abstract

摘要： 目的:探讨氧化应激（oxidative stress,OS）在慢性牙周炎（chronic periodontitis,CP）与代谢功能障碍相关脂肪肝病（metabolic dysfunction-associated steatotic liver disease,MASLD）中的潜在作用及机制。方法:选取2024年10月—2025年2月在安徽医科大学第四附属医院就诊的162例患者,分为单纯CP组（n=42）、单纯MASLD组（n=41）、共病组（n=39）及健康组（n=40）。检测各组患者唾液中的丙二醛（malondialdehyde,MDA）和超氧化物歧化酶（superoxide dismutase,SOD）水平,同时检测牙周探诊深度（periodontal depth,PD）、附着丧失（attachment loss,AL）及肝脏硬度值（liver stiffness measurement, LSM）,并进行统计分析。结果:共病组的PD和AL值显著高于单纯CP组（P<0.05）,且共病组和单纯CP组的PD和AL值均显著高于健康组和单纯MASLD组（P<0.05）。OS指标显示,唾液MDA水平按健康组、单纯CP组、单纯MASLD组、共病组的顺序递增,而唾液SOD活性则依次递减,组间差异均有统计学意义（P<0.001）;作为OS综合评估指标,共病组的唾液MDA/SOD比值显著高于其他组（P<0.001）。在单纯CP与单纯MASLD患者中,其疾病严重度与OS水平呈正相关,重度组的MDA水平和MDA/SOD比值显著高于轻中度组,SOD活性则显著低于轻中度组（P<0.001）。基于Bootstrap法的中介效应模型（PROCESS Macro Model 4）分析显示,MDA/SOD比值在PD与LSM的关系中发挥部分中介作用,效应值为0.359 kPa,可解释37%的肝损伤总影响程度。结论:OS水平与CP和MASLD的发病及严重程度呈正相关,在CP与MASLD共病患者中,OS失衡程度与牙周及肝脏损伤指标显示出协同关联性。唾液作为无创OS标志物的检测样本,适用性良好,在共病筛查与疗效监测中具有应用潜力。

关键词: 氧化应激, 慢性牙周炎, 代谢功能障碍相关脂肪肝病, 丙二醛, 超氧化物歧化酶

Abstract: PURPOSE: To explore the correlation and mechanism of oxidative stress (OS) in the co-morbidity of chronic periodontitis (CP) and metabolic dysfunction-associated steatotic liver disease (MASLD). METHODS: A total of 162 patients who visited the Fourth Affiliated Hospital of Anhui Medical University from September 2024 to February 2025 were selected and divided into the simple CP group (n=42), the simple MASLD group (n=41), the comorbid group (n=39) and the healthy group (n=40). The salivary malondialdehyde (MDA), superoxide dismutase (SOD), periodontal depth (PD), attachment loss (AL) and liver stiffness measurement (LSM) of each group were detected, and statistical analysis was carried out. Results: In terms of periodontal indicators, the PD and AL values of patients in the comorbid group were significantly higher than that of the simple CP group (P< 0.05). In addition, the PD and AL values of the comorbid group and the simple CP group were significantly higher than those of the healthy group and the simple MASLD group (P< 0.05). The OS indicators showed that the MDA level of saliva increased in the order of healthy people, simple CP group, simple MASLD group and comorbid group, while the SOD activity of saliva decreased in order, and the differences between the groups were statistically significant (P< 0.001). As an indicator of comprehensive OS evaluation, the saliva MDA/SOD ratio of the comorbid group was significantly higher than that of all other groups (P< 0.001). In patients with simple CP and simple MASLD, the disease severity and OS level showed a positive correlation, the MDA level and MDA/SOD ratio of the severe group were significantly higher than that of the mild-moderate group, while the SOD activity was significantly lower (P< 0.001). Through the analysis of the intermediary effect model (PROCESS Macro Model 4) based on the Bootstrap method, it was found that the MDA/SOD ratio plays a partial intermediary role in the relationship between PD and LSM, and its effect value was 0.359 kPa, which explained 37% of the total impact on liver injury. CONCLUSIONS: OS level is positively correlated with CP and MASLD and their severity, and in patients with CP and MASLD co-disease, the degree of OS imbalance shows a synergistic correlation with periodontal and liver injury indicators. As a test sample for non-invasive OS markers, saliva has good applicability and potential for application in co-morbidity screening and efficacy monitoring.

Key words: Oxidative stress, Chronic periodontitis, Metabolic dysfunction-associated steatotic liver disease, MDA, SOD

中图分类号:

谢一瑾, 李豪杰, 丁红忠. 氧化应激在慢性牙周炎与代谢功能障碍相关脂肪肝病中的潜在作用及机制探讨[J]. 上海口腔医学, 2026, 35(2): 192-198.

Xie Yijin, Li Haojie, Ding Hongzhong. Exploration of the potential role and mechanism of oxidative stress in chronic periodontitis and metabolic dysfunction-associated steatotic liver disease[J]. Shanghai Journal of Stomatology, 2026, 35(2): 192-198.

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