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1型糖尿病合并牙周炎患者临床与微生物学变量的关系。

Relationship of clinical and microbiological variables in patients with type 1 diabetes mellitus and periodontitis.

作者信息

Sakalauskiene Jurgina, Kubilius Ricardas, Gleiznys Alvydas, Vitkauskiene Astra, Ivanauskiene Egle, Šaferis Viktoras

机构信息

Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Department of Maxillofacial Surgery and Surgical Stomatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Med Sci Monit. 2014 Oct 8;20:1871-7. doi: 10.12659/MSM.890879.

Abstract

BACKGROUND

The aim of the study was to analyze how metabolic control of type 1 diabetes is related to clinical and microbiological periodontal parameters.

MATERIAL AND METHODS

The study involved 56 subjects aged from 19 to 50 years divided into 2 groups: healthy subjects (the H group), and diabetic (type 1 diabetes) patients with chronic untreated generalized periodontitis (the DM group). The glycosylated hemoglobin value (HbA1c) was determined using the UniCel DxC 800 SYNCHRON System (Beckman Coulter, USA), and the concentration in blood was measured by the turbidimetric immunoinhibition method. A molecular genetic assay (Micro-IDent plus, Germany) was used to detect periodontopathogenic bacteria in plaque samples. Periodontitis was confirmed by clinical and radiological examination.

RESULTS

Fusobacterium nucleatum, Capnocytophaga species, and Eikenella corrodens were the most frequently found bacteria in dental plaque samples (77.8%, 66.7%, and 33.4%, respectively), whereas Aggregatibacter actinomycetemcomitans was identified 40.7% less frequently in the DM group than in the H group. The strongest relationship was observed between the presence of 2 periodontal pathogens - F. nucleatum and Capnocytophaga spp. - and poorer metabolic control in type 1 diabetes patients (HbA1c) and all clinical parameters of periodontal pathology.

CONCLUSIONS

Periodontal disease was more evident in type 1 diabetic patients, and the prevalence of periodontitis was greatly increased in subjects with poorer metabolic control.

摘要

背景

本研究旨在分析1型糖尿病的代谢控制与临床及微生物学牙周参数之间的关系。

材料与方法

本研究纳入了56名年龄在19至50岁之间的受试者,分为两组:健康受试者(H组)和患有未经治疗的慢性广泛性牙周炎的糖尿病(1型糖尿病)患者(DM组)。使用UniCel DxC 800 SYNCHRON系统(美国贝克曼库尔特公司)测定糖化血红蛋白值(HbA1c),并采用比浊免疫抑制法测量血液中的浓度。使用分子遗传学检测方法(德国Micro-IDent plus)检测菌斑样本中的牙周病原菌。通过临床和影像学检查确诊牙周炎。

结果

具核梭杆菌、二氧化碳嗜纤维菌属和腐蚀埃肯菌是牙菌斑样本中最常发现的细菌(分别为77.8%、66.7%和33.4%),而在DM组中伴放线聚集杆菌的检出率比H组低40.7%。在1型糖尿病患者中,两种牙周病原体——具核梭杆菌和二氧化碳嗜纤维菌属——的存在与较差的代谢控制(HbA1c)以及牙周病理学的所有临床参数之间存在最强的相关性。

结论

1型糖尿病患者的牙周疾病更为明显,代谢控制较差的受试者中牙周炎的患病率大大增加。

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