评估Dickkopf-1作为生物标志物:对牙周炎、类风湿性关节炎及其合并症的见解——一项系统综述和荟萃分析

IF 1.8 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Frontiers in dental medicine Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI:10.3389/fdmed.2025.1593218
Bawatharani Maharavi, Jaideep Mahendra, Deepa Ponnaiyan, Vijayalakshmi Rajaram, Pragya Gyanchand, Roshan R Rughwani, Kaustubh Suresh Thakare, Gayathri Kumar, Gauri Patil
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引用次数: 0

摘要

背景:Dickkopf-1是一种糖蛋白,可抑制无翼相关整合位点信号,损害成骨细胞和破骨细胞功能,导致骨质流失和与牙周炎和类风湿性关节炎相关的全身性炎症。牙龈卟啉单胞菌通过瓜氨酸化和炎症加剧类风湿关节炎,突出两者的双向关系。到目前为止,还没有荟萃分析研究Dickkopf-1在牙周炎、类风湿性关节炎及其合并症中的作用。因此,我们进行了这项荟萃分析,以调查Dickkopf-1在这些合并症中的关联和作用。方法:本研究按照系统评价和meta分析透明报告PRISMA声明的指导方针进行(在PROSPERO注册,编号为CRD42025643227)。从PubMed和谷歌Scholar等数据库(由BM、JM和DP)中共选择了15项研究(14项病例对照和1项横断面研究)。随机效应模型通过标准化平均差(SMD)和95%置信区间(CI)评估牙周炎和类风湿关节炎患者血清/龈沟液中Dickkopf-1水平。采用统计指标、森林图、漏斗图、Begg检验和Egger回归评估异质性和发表偏倚。结果:共检索到386项研究,其中15项纳入荟萃分析,包括4,438名参与者(2,190例和2,248例对照)。合并SMD为2.694 (p = 0.02;95% CI: 1.170-6.203)表明与健康对照相比,Dickkopf-1与牙周炎和/或类风湿性关节炎有显著相关性。然而,Egger检验显示t值为3.05 (p = 0.009),表明显著的发表偏倚。结论:在类风湿关节炎和牙周炎患者中Dickkopf-1水平升高提示其在两种疾病的发病机制中起关键作用。因此,Dickkopf-1在治疗相互关联的炎症和骨骼疾病方面具有治疗潜力,并可能作为诊断这些疾病的生物标志物。系统评价注册:https://www.crd.york.ac.uk/PROSPERO/search, PROSPERO CRD42025643227。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Evaluating Dickkopf-1 as a biomarker: insights into periodontitis, rheumatoid arthritis, and their comorbidity-a systematic review and meta-analysis.

Evaluating Dickkopf-1 as a biomarker: insights into periodontitis, rheumatoid arthritis, and their comorbidity-a systematic review and meta-analysis.

Evaluating Dickkopf-1 as a biomarker: insights into periodontitis, rheumatoid arthritis, and their comorbidity-a systematic review and meta-analysis.

Evaluating Dickkopf-1 as a biomarker: insights into periodontitis, rheumatoid arthritis, and their comorbidity-a systematic review and meta-analysis.

Background: Dickkopf-1 is a glycoprotein that inhibits Wingless-related integration site signaling, impairing osteoblast and osteoclast functions, leading to bone loss and systemic inflammation linked to periodontitis and rheumatoid arthritis. Porphyromonas gingivalis exacerbates rheumatoid arthritis through citrullination and inflammation, highlighting their bidirectional relationship. To date no meta-analysis has examined the role of Dickkopf-1 in periodontitis, rheumatoid arthritis, and their comorbidity. Therefore, we conducted this meta-analysis to investigate the association and role of Dickkopf-1 in these comorbid conditions.

Methods: The present study was conducted in accordance with the guidelines of Transparent Reporting of Systematic Reviews and Meta-Analyses PRISMA statement (registered at PROSPERO under the number CRD42025643227). A total of 15 studies (14 case-control and 1 cross-sectional) were selected out of 386 using databases like PubMed and Google Scholar (by BM, JM, and DP). A random-effects model evaluated Dickkopf-1 levels in serum/gingival crevicular fluid in periodontitis and rheumatoid arthritis via standardized mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity and publication bias were assessed using statistical metrics, forest plots, funnel plots, Begg's test, and Egger's regression.

Results: A total of 386 studies were retrieved and 15 were included in the meta-analysis, encompassing 4,438 participants (2,190 cases and 2,248 controls). The pooled SMD of 2.694 (p = 0.02; 95% CI: 1.170-6.203) indicated a significant association of Dickkopf-1 with periodontitis and/or rheumatoid arthritis compared to healthy controls. However, Egger's test revealed a t-value of 3.05 (p = 0.009), indicating significant publication bias.

Conclusion: Elevated Dickkopf-1 levels in rheumatoid arthritis and periodontitis patients suggest its critical role in the pathogenesis of both conditions. Hence, Dickkopf-1 holds therapeutic potential for managing interconnected inflammatory and bone disorders and may serve as a biomarker for diagnosing these diseases.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/search, PROSPERO CRD42025643227.

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