BackgroundThe aim of this study was to investigate the potential association between vitamin D deficiency and matrix metalloproteinase‐9 (MMP‐9) levels in gingival crevicular fluid (GCF) across various periodontal health and disease statuses.MethodsA total of 200 volunteers were divided into two groups according to serum vitamin D concentration (25(OH)D < 10 ng/mL and 25(OH)D ≥ 10 ng/mL). Periodontal health status was determined based on a full‐mouth periodontal examination and radiographic evaluation. Participants in both groups were categorized according to periodontal diagnoses, encompassing periodontal health, gingivitis, and periodontitis. Following sampling, the MMP‐9 levels in GCF were determined by the enzyme‐linked immunosorbent assay (ELISA) method.ResultsThe GCF MMP‐9 levels were found to be higher in individuals with serum 25(OH)D < 10 ng/mL, in both the healthy and gingivitis and periodontitis groups, compared to those with 25(OH)D ≥ 10 ng/mL. Nevertheless, a statistically significant distinction was observed exclusively within the gingivitis and periodontitis groups. Correlation analysis and robust regression analyses provided additional evidence supporting the predictive role of periodontal disease status and vitamin D concentration in local MMP‐9 levels. These associations remained significant after adjusting for age and sex in robust regression analysis (p = 0.002). Furthermore, the inclusion of periodontal clinical parameters in the regression analysis revealed notable associations of clinical attachment loss with local MMP‐9 levels, along with periodontal disease status and serum vitamin D concentration (p < 0.001).ConclusionThe findings of our study suggest a potential mechanistic relationship between serum vitamin D levels and periodontitis.PLAIN LANGUAGE SUMMARYVitamin D deficiency is a widespread issue globally due to urban living, less outdoor time, seasonal changes, aging, and sunscreen use, leading to inadequate sun exposure. Low vitamin D levels are linked to several health problems, including hypertension, diabetes, heart diseases, and periodontal diseases, which affect the gums and bones around teeth and can cause tooth loss if untreated. Although the link between vitamin D and periodontal disease is unclear, it may involve the enzyme matrix metalloproteinase‐9 (MMP‐9). Our study examined 200 people, dividing them into two groups based on vitamin D levels. We assessed their gum health and measured MMP‐9 levels in their gingival crevicular fluid, a liquid that seeps out from the tiny space between gums and teeth. We found that people with lower vitamin D levels had higher MMP‐9 levels, especially those with gum disease. Our analysis showed that both vitamin D levels and gum health significantly impact MMP‐9 levels, with gum health being the more influential factor. Maintaining good gum health and adequate vitamin D levels is crucial for managing MMP‐9, an enzyme critical for tissue remodeling during healing and inflammation. However, excessive MMP may rapidly destroy periodontal tissues.

中文翻译：

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牙周疾病中血清维生素 D 浓度与基质金属蛋白酶-9 水平呈负相关


背景本研究的目的是调查不同牙周健康和疾病状态下维生素 D 缺乏与龈沟液 (GCF) 中基质金属蛋白酶 9 (MMP-9) 水平之间的潜在关联。方法总共 200 名志愿者被分为两组根据血清维生素 D 浓度进行分组（25(OH)D < 10 ng/mL 和 25(OH)D ≥ 10 ng/mL）。牙周健康状况是根据全口牙周检查和放射学评估确定的。两组参与者均根据牙周诊断进行分类，包括牙周健康、牙龈炎和牙周炎。采样后，通过酶联免疫吸附测定 (ELISA) 方法测定 GCF 中的 MMP-9 水平。结果发现血清 25(OH)D < 10 ng/mL 的个体中 GCF MMP-9 水平较高，在健康组和牙龈炎及牙周炎组中，与 25(OH)D ≥ 10 ng/mL 的组相比。然而，仅在牙龈炎和牙周炎组中观察到统计学上的显着差异。相关分析和稳健回归分析提供了额外的证据，支持牙周疾病状态和维生素 D 浓度在局部 MMP-9 水平中的预测作用。在稳健回归分析中调整年龄和性别后，这些关联仍然显着 (p = 0.002)。此外，回归分析中纳入的牙周临床参数揭示了临床附着丧失与局部 MMP-9 水平以及牙周疾病状态和血清维生素 D 浓度之间的显着相关性 (p < 0.001)。 结论 我们的研究结果表明血清维生素 D 水平与牙周炎之间的潜在机制关系。通俗语言摘要由于城市生活、户外时间减少、季节变化、衰老和防晒霜使用导致阳光照射不足，维生素 D 缺乏症是全球范围内普遍存在的问题。维生素 D 水平低与多种健康问题有关，包括高血压、糖尿病、心脏病和牙周病，这些疾病会影响牙齿周围的牙龈和骨骼，如果不及时治疗，可能会导致牙齿脱落。尽管维生素 D 与牙周病之间的联系尚不清楚，但可能涉及基质金属蛋白酶-9 (MMP-9)。我们的研究调查了 200 人，根据维生素 D 水平将他们分为两组。我们评估了他们的牙龈健康状况，并测量了龈沟液中 MMP-9 的水平，龈沟液是一种从牙龈和牙齿之间的微小间隙渗出的液体。我们发现维生素 D 水平较低的人，尤其是患有牙龈疾病的人，MMP-9 水平较高。我们的分析表明，维生素 D 水平和牙龈健康都会显着影响 MMP-9 水平，其中牙龈健康是影响更大的因素。保持良好的牙龈健康和充足的维生素 D 水平对于控制 MMP-9 至关重要，MMP-9 是一种在愈合和炎症过程中对组织重塑至关重要的酶。然而，过量的MMP可能会迅速破坏牙周组织。