Oral Public Health Department, Institute of Odontology, University of Copenhagen, Norre Alle 20, 2200, Copenhagen, Denmark.
Clin Oral Investig. 2013 Apr;17(3):967-74. doi: 10.1007/s00784-012-0760-y. Epub 2012 May 31.
The aim of this study was to assess the relationship between tooth loss, toothbrushing behaviour, diabetes type 2 (DM2), obesity and sleep apnea among diabetics.
DM2 patients (n = 165) in Istanbul, Turkey, were randomly selected from the outpatient clinics of two hospitals. Baseline clinical measurements (HbA1c, fasting blood glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), body mass index (BMI), body-fat proportion, tooth loss) and self-administered questionnaires (toothbrushing, gingival bleeding, sleep apnea) provided data for factor and principal component analysis with Varimax rotation. Univariate statistics and chi-square tests were derived.
Mean maxillary tooth loss (4.49 ± 3.69 teeth) was higher than in the mandible (3.43 ± 3.12 teeth, p< 0.001). Favourable HDL was measured among most patients (77%); other favourable clinical measures occurred only in a minority of participants (HbA1c, 28%; fasting blood glucose, 17%; LDL, 30%). Twice daily toothbrushing was reported by 33% (17%) for healthy BMI; 37% when healthy body-fat proportions. There was risk of sleep apnea in 37 %. The higher number of lost teeth in the maxilla was linked with obesity and sleep apnea. Non-daily toothbrushers were more likely to have high LDL and low HDL cholesterol and a higher risk of sleep apnea. When "at least occasionally" bleeding on toothbrushing occurred, higher HbA1c levels and sleep apnea were more likely.
Oral care with early diagnosis and monitoring of glycaemic level can help prevent complications of DM2.
Dentists may play a key role in better managing and diagnosing sleep apnea early by referring the patients with severe tooth loss and periodontal disease for general medical examination.
本研究旨在评估牙齿缺失、刷牙行为、2 型糖尿病（DM2）、肥胖和睡眠呼吸暂停之间的关系。
在土耳其伊斯坦布尔，从两家医院的门诊中随机选择 DM2 患者（n=165）。基线临床测量（HbA1c、空腹血糖、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、体重指数（BMI）、体脂肪比例、牙齿缺失）和自我管理问卷（刷牙、牙龈出血、睡眠呼吸暂停）为因素和主成分分析提供数据，采用 Varimax 旋转。进行单变量统计和卡方检验。
上颌牙齿缺失的平均值（4.49±3.69 颗）高于下颌（3.43±3.12 颗，p<0.001）。大多数患者的 HDL 良好（77%）；其他有利的临床指标仅在少数参与者中出现（HbA1c，28%；空腹血糖，17%；LDL，30%）。健康 BMI 的患者中有 33%（17%）报告每天刷牙两次；健康体脂比例的患者中有 37%。有 37%的患者有睡眠呼吸暂停风险。上颌牙齿缺失较多与肥胖和睡眠呼吸暂停有关。非每日刷牙者更有可能出现 LDL 高、HDL 胆固醇低和睡眠呼吸暂停风险高。当出现“偶尔”刷牙出血时，更可能出现 HbA1c 水平升高和睡眠呼吸暂停。
通过早期诊断和监测血糖水平进行口腔护理，可以帮助预防 DM2 的并发症。
牙医可以通过转介严重牙齿缺失和牙周病患者进行一般体检，在早期更好地管理和诊断睡眠呼吸暂停方面发挥关键作用。
