上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (3): 281-285.doi: 10.19439/j.sjos.2025.03.011

• 论著 • 上一篇    下一篇

龈沟液miR-146a-5p、PI3K、Akt对慢性牙周炎严重程度的预测价值

高佳明1, 张耐新2, 岳佳胜1   

  1. 1.北京大学第三医院秦皇岛医院 口腔科,河北 秦皇岛 066000;
    2.华北医疗健康集团峰峰总医院 口腔科,河北 邯郸 056201
  • 收稿日期:2025-01-17 修回日期:2025-03-14 出版日期:2025-06-25 发布日期:2025-06-24
  • 通讯作者: 张耐新,E-mail: gjmwazddzaw@163.com
  • 作者简介:高佳明（1987-）,男,本科,主治医师,E-mail: 16630501350@163.com
  • 基金资助:
    河北省卫生健康委医学科学研究课题计划项目(20241073)

Prediction value of miR-146a-5p, PI3K and Akt in gingival crevicular fluid on the severity of chronic periodontitis

Gao Jiaming1, Zhang Naixin2, Yue Jiasheng1   

  1. 1. Department of Stomatology, Qinhuangdao Hospital, Peking University Third Hospital.Qinhuangdao 066000;
    2. Department of Stomatology, Fengfeng General Hospital, North China Medical and Health Group. Handan 056201, Hebei Province, China
  • Received:2025-01-17 Revised:2025-03-14 Online:2025-06-25 Published:2025-06-24

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摘要： 目的: 探讨龈沟液中microRNA-146a-5p（miR-146a-5p）、磷酯酰肌醇3激酶（phosphatidylinositol-3-kinase,PI3K）和蛋白激酶B（protein kinase B,Akt）对慢性牙周炎（chronic periodontitis,CP）严重程度的预测价值。方法: 选择北京大学第三医院秦皇岛医院2021年3月—2024年3月收治的121例CP患者,根据病情严重程度分为轻中度组（85例）和重度组（36例）。检测患者龈沟液中miR-146a-5p、PI3K和Akt水平,并检测牙周袋探诊深度（probing depth,PD）、临床附着丧失（clinical attachment loss,CAL）及牙龈出血指数（sulcus bleeding index,SBI）等牙周指标,分析影响CP严重程度的因素。采用受试者工作特征（receiver-operating characteristic, ROC）曲线下面积（area under the curve, AUC）分析miR-146a-5p、PI3K和Akt对CP严重程度的预测价值。结果: 重度组miR-146a-5p、PI3K、Akt、PD、CAL、合并糖尿病占比和吸烟史占比显著高于轻中度组（P<0.05）。Logistic回归分析结果显示,合并糖尿病（OR=3.252,95%CI：1.312~8.059）、miR-146a-5p水平（OR=5.273,95%CI：2.469~11.258）、PI3K水平（OR=4.877,95%CI：1.812~13.123）和Akt水平（OR=4.421,95%CI：1.669~11.710）是影响CP严重程度的独立危险因素（P<0.05）。ROC结果显示,miR-146a-5p、PI3K、Akt及三者联合预测CP严重程度的AUC分别为0.801、0.789、0.772和0.898（P<0.05）。结论: 龈沟液中miR-146a-5p、PI3K和Akt水平是CP严重程度的独立危险因素,三者联合检测可较好预测患者病情严重程度。

关键词: 慢性牙周炎, miR-146a-5p, 磷酯酰肌醇3激酶, 蛋白激酶B, 病情严重程度, 影响因素, 预测价值

Abstract: PURPOSE: To investigate the predictive value of microRNA-146a-5p (miR-146a-5p), phosphatidylinositol 3 kinase (PI3K) and protein kinase B (Akt) in gingival crevicular fluid for the severity of chronic periodontitis (CP). METHODS: A total of 121 CP patients admitted to Qinhuangdao Hospital of Peking University Third Hospital from March 2021 to March 2024 were selected. According to the severity of the disease, the patients were divided into mild-to-moderate group(n=85) and severe group(n=36). The levels of miR-146a-5p, PI3K and Akt in gingival crevicular fluid were detected, and probing depth(PD), clinical attachment loss(CAL), sulcus bleeding index(SBI) were collected to analyze the factors affecting the severity of CP. Area under the curve (AUC) of receiver operating characteristic (ROC) was used to analyze the predictive value of miR-146a-5p, PI3K and Akt in CP severity. RESULTS: The miR-146a-5p, PI3K, Akt, probing depth(PD), the level of clinical attachment loss (CAL), the ratio of combined diabetes and the smoking history in the severe group were significantly higher than those in the mild-moderate group(P<0.05). Logistic regression analysis showed that diabetes mellitus(OR=3.252, 95%CI: 1.312-8.059), miR-146a-5p level(OR=5.273, 95%CI: 2.469-11.258), PI3K level (OR=4.877, 95%CI: 1.812-13.123) and Akt level (OR=4.421, 95%CI: 1.669-11.710) were independent risk factors affecting the severity of the disease(P<0.05). ROC results showed that the AUC of miR-146a-5p, PI3K, Akt and their combined prediction of CP severity were 0.801, 0.789, 0.772 and 0.898, respectively(P<0.05). CONCLUSIONS: The levels of miR-146a-5p, PI3K and Akt in gingival crevicular fluid are independent risk factors for CP severity, and combined detection of the three parameters can better predict the severity of patients' disease.

Key words: Chronic periodontitis, Microrna-146a-5p, Phosphatidylinositol 3-kinase, Protein kinase B, Severity of illness, Influencing factors, Predictive value

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