Аннотация
Purpose of the study. Comparison of the composition of the periodontal and intestinal microbiome in individuals with chronic periodontitis against the background of obesity and intestinal dysbiosis with a control group of healthy individuals using the real-time PCR method. Material and methods. A total of 65 individuals of both sexes participated in the clinical study. The main group consisted of 35 individuals aged 45-59 years with a diagnosis of moderate chronic generalized periodontitis (ICD K 05.3), morbid obesity (ICD 10: E66.0 / E66.2 / E66.8 / E66.9) and intestinal dysbacteriosis (ICD 10: R19.8). The control group included 30 healthy volunteers. The study design was a prospective comparative study in two groups. Participants in both groups underwent a study of the total amount of bacterial mass in the exudate of periodontal pockets / gingival sulcus and colonic contents, and the species composition of the microflora was also determined by the real-time PCR method. StatTech v. 2.8.8 (NPO DNA-Technology, Russia) and Statistica 12.0 (StatSoft, USA) were used for statistical analysis of the obtained results. Results and discussion. The study showed that the total bacterial count of both the subgingival microflora and intestinal contents in patients with chronic generalized periodontitis and morbid obesity was higher compared to the control group of subjects with an intact periodontium and no somatic pathology. High correlation coefficients between the total bacterial count in periodontal exudate and intestinal contents in patients of the study group (R = 0.79 at p < 0.001) indicated a close relationship between the state of the oral microbiota and the microbiota of the lower gastrointestinal tract. Patients with periodontitis and morbid obesity more often had higher levels of A. actinomycetemcomitans, T. forsythia, P. gingivalis, and T. denticola in the microflora of periodontal pockets, compared to the gingival sulcus fluid in the control group. In the intestinal contents, almost all the studied microbes, except Neisseria spp., were found in all patients, both in the main and control groups, but the frequency of detection of Neisseria spp. in the feces of patients in the main group (42.9 %) was higher compared to the control group (6.7 %) (p = 0.003). The number of Enterobacterium spp. in the feces of patients in the main group compared to the control was 39.4 times higher (p < 0.001), Eubacterium spp. – 32 times (p < 0.001), and Neisseria spp. – 3.8 times (p < 0.001). Conclusions. In patients with morbid obesity, dysbiotic changes in the oral cavity are associated with intestinal dysbiosis. In this pathology, high levels of A. actinomycetemcomitans, T. forsythia, P. gingivalis, and T. denticola are observed in the periodontal pocket microflora, in contrast to the gingival sulcus fluid of patients without dental or somatic pathology. Enterobacterium spp., Eubacterium spp., and Neisseria spp. predominate in the intestinal contents of patients with periodontitis associated with obesity.