Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital and Institute of Dentistry, University of Helsinki, Helsinki, Finland.
Clin Oral Investig. 2011 Feb;15(1):99-104. doi: 10.1007/s00784-009-0360-7. Epub 2010 Jan 19.
We investigated oral health of chronic kidney disease (CKD) patients at predialysis state. The hypothesis was that diabetic nephropathy affects oral health more detrimentally than other CKD patients due to the known risk diabetes presents in this regard. We expected worse oral health and particularly poor periodontal health among the diabetic patients. A cross-sectional study was conducted in the Helsinki University Central Hospital, Finland, on 148 patients with different kinds of kidney disease at predialysis state. Data from medical records, clinical oral examination, saliva, and mucosal yeast counts were analyzed and compared between the disease groups. Of the patients, 53 (36%) had diabetic nephropathy (29 patients with type 1, 24 patients with type 2 diabetes). Compared with other CKD patients, diabetic patients had poor glycemic control as expected (mean HbA(1C) 8.0% vs 5.9%, p < 0.01). Diabetic patients also had more dental caries (mean number of carious teeth 5.1 vs 3.1, p < 0.01) and lower salivary flow rates than other CKD patients (stimulated salivary flow 1.2 ml/min vs 1.6 ml/min, p < 0.05). No difference between groups was observed in periodontal health and yeast counts. In conclusion, diabetic nephropathy patients indeed had worse dental health in comparison to CKD group. However, contrary to our expectation, diabetic nephropathy did not seem to affect periodontal health more severely than the other kidney diseases.
我们研究了慢性肾脏病(CKD)患者在透析前的口腔健康状况。我们的假设是,由于糖尿病在这方面存在已知的风险,糖尿病肾病对口腔健康的影响比其他 CKD 患者更不利。我们预计糖尿病患者的口腔健康状况更差,尤其是牙周健康状况更差。这项横断面研究在芬兰赫尔辛基大学中心医院进行,共有 148 名处于透析前状态的不同类型肾病患者参与。对病历、临床口腔检查、唾液和黏膜酵母计数的数据进行了分析,并在疾病组之间进行了比较。在这些患者中,有 53 名(36%)患有糖尿病肾病(1 型糖尿病 29 例,2 型糖尿病 24 例)。与其他 CKD 患者相比,糖尿病患者的血糖控制确实较差(平均 HbA1C 为 8.0%,而其他 CKD 患者为 5.9%,p<0.01)。与其他 CKD 患者相比,糖尿病患者的龋齿也更多(平均龋齿数为 5.1,而其他 CKD 患者为 3.1,p<0.01),唾液流量也较低(刺激后唾液流量为 1.2ml/min,而其他 CKD 患者为 1.6ml/min,p<0.05)。在牙周健康和酵母计数方面,各组之间没有差异。总之,与 CKD 组相比,糖尿病肾病患者的口腔健康状况确实更差。然而,与我们的预期相反,糖尿病肾病似乎并没有比其他肾脏疾病更严重地影响牙周健康。
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