牙周病與糖尿病、維他命D的關係－近期觀點探討

Relationship between Periodontitis, Diabetes and Vitamin D: A Review of Current Research

李宜芳(Lee F. Chen) ； 陳玄祐(Shyuan-Yow Chen) ； 楊岳炤(Yueh-Chao Yang)

《臺灣牙周病醫學會雜誌》 20卷4期 (2015/12) Pp. 300-308

https://doi.org/10.6121/TAP.2015.20.4.05

摘要

糖尿病（diabetes mellitus, DM）和牙周病（periodontitis）兩者在致病機轉上都因為造成局部性或系統性的發炎反應，成為互相影響的慢性病。牙菌斑是牙周病的致病因子，若從免疫學的角度上看，活化的維生素D（1,25-dihydroxyvitamin D; 1,25(OH)_2D，簡稱25OHD），通過誘導抗菌胜肽cathelicidin（LL-37）和其他防禦素（defensins），可以有效對抗細菌感染。攝取足夠的維生素D對於減少牙周炎的風險似乎是合理的期待。維生素D可調節第2型糖尿病的風險，並且在牙周膜細胞中占有重要角色，透過細胞激素的產生來調控牙周發炎的機制。牙周病、糖尿病、維他命D三者應有互相影響的機制，仍待臨床隨機對照試驗證實。

關鍵字

牙周病 ； 糖尿病 ； 維他命D ； 骨吸收 ； 發炎情況

並列摘要

Diabetes mellitus and periodontitis both shared a common pathogenesis that involves an increase in the inflammatory response at either the local or systemic level. Since dental plaque bacteria are important risk factors for periodontitis and it is known that activated vitamin D [1,25-dihydroxyvitamin D; 1,25(OH)_2D], through an induction of cathelicidin (LL-37) and other defensins, is able to effectively fight bacterial infection. It seems reasonable that the maintenance of an adequate level of vitamin D might be able to reduce the risk of periodontitis. Vitamin D may also modify the risk of type 2 diabetes mellitus. Furthermore, activated vitamin D might also play an important role in the modulation of periodontal inflammation via the regulation of cytokine production by cells in the periodontal ligament. Periodontal disease, diabetes and vitamin D form a triangle that seems to involve mutual influences; nevertheless, there remains a need for clinical evidence of these interactions by, for example, carrying out randomized controlled trials.

並列關鍵字

Periodonitis ； diabetes mellitus ； vitamin D ； bone resorption ； inflammatory status