Division of Periodontics, College of Dental Medicine, Columbia University, 630 West 168th Street, PH7E-110, New York, NY 10032, USA.
Nat Rev Endocrinol. 2011 Jun 28;7(12):738-48. doi: 10.1038/nrendo.2011.106.
Diabetes mellitus (a group of metabolic disorders characterized by hyperglycemia) and periodontitis (a microbially induced inflammatory disorder that affects the supporting structures of teeth) are both common, chronic conditions. Multiple studies have demonstrated that diabetes mellitus (type 1 and type 2) is an established risk factor for periodontitis. Findings from mechanistic studies indicate that diabetes mellitus leads to a hyperinflammatory response to the periodontal microbiota and also impairs resolution of inflammation and repair, which leads to accelerated periodontal destruction. The cell surface receptor for advanced glycation end products and its ligands are expressed in the periodontium of individuals with diabetes mellitus and seem to mediate these processes. The association between the two diseases is bidirectional, as periodontitis has been reported to adversely affect glycemic control in patients with diabetes mellitus and to contribute to the development of diabetic complications. In addition, meta-analyses conclude that periodontal therapy in individuals with diabetes mellitus can result in a modest improvement of glycemic control. The effect of periodontal infections on diabetes mellitus is potentially explained by the resulting increase in levels of systemic proinflammatory mediators, which exacerbates insulin resistance. As our understanding of the relationship between diabetes mellitus and periodontitis deepens, increased patient awareness of the link between diabetes mellitus and oral health and collaboration among medical and dental professionals for the management of affected individuals become increasingly important.
糖尿病（一组以高血糖为特征的代谢紊乱）和牙周炎（一种由微生物引起的炎症性疾病，影响牙齿的支持结构）都是常见的慢性疾病。多项研究表明，糖尿病（1 型和 2 型）是牙周炎的既定危险因素。机制研究的结果表明，糖尿病导致对牙周微生物群的过度炎症反应，并且还损害炎症和修复的解决，从而导致牙周破坏加速。在糖尿病患者的牙周组织中表达细胞表面晚期糖基化终产物受体及其配体，并且似乎介导这些过程。这两种疾病之间的关联是双向的，因为据报道牙周炎会对糖尿病患者的血糖控制产生不利影响，并有助于糖尿病并发症的发展。此外，荟萃分析得出结论，牙周治疗可以使糖尿病患者的血糖控制略有改善。牙周感染对糖尿病的影响可以通过全身促炎介质水平的升高来解释，这会加剧胰岛素抵抗。随着我们对糖尿病和牙周炎之间关系的理解加深，患者对糖尿病和口腔健康之间联系的认识增加以及医学和牙科专业人员之间为受影响个体进行管理的合作变得越来越重要。
