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牙周治疗对糖尿病和非糖尿病肥胖患者的临床及全身影响。

The clinical and systemic effects of periodontal treatment in diabetic and non-diabetic obese patients.

作者信息

Taşdemir Zekeriya, Özsarı Taşdemir Funda, Koçyiğit İsmail, Yazıcı Cevat, Gürgan Cem A

机构信息

Department of Periodontology, Faculty of Dentistry, Erciyes University.

出版信息

J Oral Sci. 2016;58(4):523-531. doi: 10.2334/josnusd.16-0163.

Abstract

The purpose of the present study was to evaluate the response to periodontal management in obese individuals with poorly controlled diabetes mellitus (DM) and obese individuals without DM. Changes in clinical and biochemical parameters were also investigated. Seventeen obese patients with poorly controlled DM and 14 obese non-DM patients with generalized chronic periodontitis were enrolled. The anthropometric measurements, periodontal parameters, and serum levels of lipid (triglyceride, high-density lipoprotein cholesterol, total cholesterol, low-density lipoprotein cholesterol) and glucose (fasting plasma glucose [FPG], insulin, insulin resistance [IR], hemoglobin [Hb]A1c) metabolism, pro-inflammatory mediators (high-sensitivity C-reactive protein, tumor necrosis factor-α [TNF-α] and Pentraxim-3), and interleukin-6 were measured before and at 3 months, and 6 months after full-mouth scaling and root planing (FM-SRP) together with full-mouth disinfection (FMD). A significant reduction in TNF-α (P < 0.001) values was observed in both groups following periodontal healing. However, significant changes in FPG (P < 0.05), HbA1C (P < 0.05), and the homeostasis model assessment of IR (HOMA-IR; P < 0.05) were only observed after 3 months in the DM group. Our findings suggest that obesity with or without DM does not seem to be a modifying factor for the clinical outcome of FM-SRP and FMD.(J Oral Sci 58, 523-531, 2016).

摘要

本研究的目的是评估肥胖且糖尿病(DM)控制不佳的个体以及无DM的肥胖个体对牙周治疗的反应。同时还研究了临床和生化参数的变化。纳入了17名肥胖且DM控制不佳的患者和14名患有广泛性慢性牙周炎的肥胖非DM患者。在全口洁治和根面平整(FM-SRP)联合全口消毒(FMD)前、治疗后3个月和6个月时,测量人体测量学指标、牙周参数、脂质(甘油三酯、高密度脂蛋白胆固醇、总胆固醇、低密度脂蛋白胆固醇)和葡萄糖(空腹血糖[FPG]、胰岛素、胰岛素抵抗[IR]、糖化血红蛋白[Hb]A1c)代谢指标、促炎介质(高敏C反应蛋白、肿瘤坏死因子-α[TNF-α]和五聚素3)以及白细胞介素-6。牙周愈合后,两组的TNF-α值均显著降低(P<0.001)。然而,仅在DM组治疗3个月后,FPG(P<0.05)、HbA1C(P<0.05)和IR的稳态模型评估(HOMA-IR;P<0.05)出现了显著变化。我们的研究结果表明,无论是否患有DM,肥胖似乎都不是FM-SRP和FMD临床疗效的影响因素。(《口腔科学杂志》58卷,523 - 531页,2016年)

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