Napora Magdalena, Grabowska Ewa, Górska Renata
Department of Oral Medicine and Periodontal Diseases, Medical University of Warsaw, Poland.
Adv Clin Exp Med. 2016 Sep-Oct;25(5):879-886. doi: 10.17219/acem/34206.
Periodontitis is considered a risk factor in many systemic diseases, including cardiovascular pathologies and diabetes. Diabetes can also exacerbate early vascular changes, mainly due to the synthesis of advanced glycosylation end-products and oxidative stress. It has not yet been fully explained whether the additional presence of periodontal disease can affect the course of atherosclerosis and left ventricle hypertrophy in diabetic patients.
The aim of the study was to assess the relationship between periodontal and cardiovascular diseases and their progression in patients with type 2 diabetes.
The study included 119 patients diagnosed with type 2 diabetes. Periodontal pocket depth (PD), clinical attachment loss (CAL), plaque index (PI) and bleeding index (BOP) were determined. Basic laboratory tests were performed. The intima-media thickness (IMT) and the left ventricular mass index (LVMI) were determined by means of ultrasonography. After one year the examinations were repeated. The statistical analysis included the 84 patients who took part in both the first and second examinations.
A positive correlation between the number of deep and active periodontal pockets and LVMI value was observed in men. The IMT value correlated with the mean CAL, PI and BOP, while a negative correlation was found between the IMT and the number of deep pockets, as well as between the IMT and the number of retained teeth. A multivariate analysis demonstrated a significant correlation between CAL and both IMT and LVMI change after one year.
A relationship between periodontitis and cardiovascular diseases has been confirmed in diabetic patients. The most significant periodontal parameter in relation to the progression of atherosclerosis and left ventricle hypertrophy was shown to be clinical attachment loss - a measure of the history of periodontal disease during the patient's lifetime.
牙周炎被认为是许多全身性疾病的危险因素，包括心血管疾病和糖尿病。糖尿病也会加剧早期血管变化，主要是由于晚期糖基化终产物的合成和氧化应激。牙周疾病的额外存在是否会影响糖尿病患者的动脉粥样硬化进程和左心室肥厚，目前尚未完全阐明。
本研究旨在评估2型糖尿病患者牙周疾病与心血管疾病之间的关系及其进展情况。
本研究纳入了119例确诊为2型糖尿病的患者。测定了牙周袋深度（PD）、临床附着丧失（CAL）、菌斑指数（PI）和出血指数（BOP）。进行了基本的实验室检查。通过超声检查测定了内膜中层厚度（IMT）和左心室质量指数（LVMI）。一年后重复进行检查。统计分析纳入了参加首次和第二次检查的84例患者。
在男性中，观察到深度和活跃牙周袋的数量与LVMI值之间呈正相关。IMT值与平均CAL、PI和BOP相关，而IMT与深袋数量以及IMT与留存牙数量之间呈负相关。多变量分析显示，CAL与一年后的IMT和LVMI变化均存在显著相关性。
已证实糖尿病患者中牙周炎与心血管疾病之间存在关联。与动脉粥样硬化进展和左心室肥厚相关的最显著牙周参数是临床附着丧失，这是衡量患者一生中牙周疾病史的指标。
