Department of Periodontics and Oral Implantology, PGIDS Post Graduate Institute of Dental Sciences, Rohtak, Haryana, 124001, India.
Department of Medicine Unit VII and Endocrinology, PGIMS Post Graduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India.
Front Med. 2017 Mar;11(1):110-119. doi: 10.1007/s11684-016-0484-5. Epub 2017 Mar 2.
This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA levels, retinopathy and nephropathy (P < 0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm, PPD 4-6 mm (%) and PPD ≥ 7 mm (%) emerged as significant predictors for elevated HbA in regression model (P < 0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.
本研究旨在探讨糖化血红蛋白与伴有慢性牙周炎的糖尿病并发症之间的关系。根据平均 PISA（牙周炎炎症表面面积）评分的三分位数，将 207 名 2 型糖尿病伴慢性牙周炎（CP）患者分为低、中、高 PISA 组。同时招募了 67 名牙周健康个体（PH）作为对照组。进行牙周检查，包括全口探诊深度（PPD）、探诊出血、临床附着水平和菌斑评分的评估。进行糖化血红蛋白（HbA）、空腹血糖（FPG）、餐后 2 小时血糖（PPG）的血液分析。PH 组的个体血糖控制明显优于 CP 组。经单因素方差分析，PISA 增加的受试者 HbA 水平、视网膜病变和肾病显著升高（P<0.05）。在校正年龄、性别、体重指数（BMI）、社会经济地位（SES）、糖尿病和牙周炎家族史、糖尿病病程后，mm 平均 PISA、4-6mm%PPD 和≥7mm%PPD 成为回归模型中 HbA 升高的显著预测因子（P<0.05）。Logistic 回归分析显示 PISA 与视网膜病变和神经病变的风险增加相关（比值比）。在本研究中，观察到了血糖控制与牙周炎相关的糖尿病并发症之间的关系。
