Frequency of periodontal pathogens and Helicobacter pylori in the mouths and stomachs of obese individuals submitted to bariatric surgery: a cross-sectional study

ABSTRACT Objectives This cross-sectional study compared the frequency of oral periodontopathogens and H. pylori in the mouths and stomachs of obese individuals with or without periodontitis submitted to bariatric surgery. Material and Methods One hundred and fifty-four men and women aged 18-65 were conveniently distributed into four groups. Two groups were composed of individuals who underwent bariatric surgery with (BP) (n=40) and without (BNP) (n=39) periodontitis and two obese control groups with (CP) (n=35) and without (CNP) (n=40) periodontitis. The oral pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, Treponema denticola, Tannerella forsythia, Campylobacter rectus, and Helicobacter pylori were detected by a polymerase chain reaction technique using saliva, tongue and stomach biopsy samples. Results Statistical analysis demonstrated that periodontopathogens were highly frequent in the mouth (up to 91.4%). In the bariatric surgically treated group, orally, P. gingivalis, T. denticola and T. forsythia were more frequent in periodontitis, while C. rectus was more frequent in non-periodontitis subjects. Stomach biopsies also revealed the high frequency of five oral species in both candidates for bariatric surgery (91.6%) and the bariatric (83.3%) groups. H. pylori was frequently detected in the mouth (50.0%) and stomach (83.3%). In the stomach, oral species and H. pylori appeared in lower frequency in the bariatric group. Conclusions Obese individuals showed high frequencies of periodontopathogens and H. pylori in their mouths and stomachs. Bariatric surgery showed an inverse microbial effect on oral and stomach environments by revealing higher oral and lower stomach bacterial frequencies.

摘要

目的 本横断面研究比较了拟接受减重手术的合并或不合并牙周炎的肥胖受试者，以及未接受减重手术的肥胖对照受试者，其口腔与胃部中口腔牙周致病菌与幽门螺杆菌（Helicobacter pylori, H. pylori）的检出频率。

材料与方法 本研究纳入154名年龄18~65岁的男女受试者，采用便利抽样法分为四组：两组为已接受减重手术的受试者，分别为合并牙周炎组（BP组，n=40）与未合并牙周炎组（BNP组，n=39）；另外两组为未接受减重手术的肥胖对照受试者，分别为合并牙周炎组（CP组，n=35）与未合并牙周炎组（CNP组，n=40）。采用聚合酶链反应（polymerase chain reaction, PCR）技术，通过唾液、舌拭子及胃部活检样本，检测以下口腔致病菌：牙龈卟啉单胞菌（Porphyromonas gingivalis）、伴放线聚集杆菌（Aggregatibacter actinomycetemcomitans）、微小微单胞菌（Parvimonas micra）、齿垢密螺旋体（Treponema denticola）、福赛斯坦纳菌（Tannerella forsythia）、直形弯曲杆菌（Campylobacter rectus）以及幽门螺杆菌。

结果 统计学分析结果显示，牙周致病菌在口腔中的检出率极高，最高可达91.4%。在已接受减重手术的受试者中，合并牙周炎者的口腔内牙龈卟啉单胞菌、齿垢密螺旋体及福赛斯坦纳菌检出率更高，而未合并牙周炎者的直形弯曲杆菌检出率更高。胃部活检样本同样显示，在拟接受减重手术组（检出率91.6%）与已接受减重手术组（检出率83.3%）中，均存在五种口腔致病菌的高检出率。幽门螺杆菌在口腔（50.0%）与胃部（83.3%）中均有较高检出率。胃部样本中，已接受减重手术组的口腔致病菌与幽门螺杆菌检出率更低。

结论 肥胖受试者的口腔与胃部中均存在较高频率的牙周致病菌与幽门螺杆菌。减重手术可对口腔与胃部微环境产生反向微生物调控效应，表现为口腔菌群检出率升高、胃部菌群检出率降低。