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非糖尿病人群中,牙周炎与胰岛素抵抗的相关性:一项横断面研究。

Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross-sectional study.

机构信息

Service of Stomatology, University Hospital Doctor Peset-FISABIO, Valencia, Spain.

Department of Stomatology, University of Valencia, Valencia, Spain.

出版信息

J Clin Periodontol. 2017 Oct;44(10):981-988. doi: 10.1111/jcpe.12773. Epub 2017 Aug 30.

Abstract

AIM

We explored the association between obesity and periodontitis with the aim of determining the possible role of insulin resistance (IR) in this relationship.

MATERIALS AND METHODS

A total of 212 subjects-110 obese and 102 lean individuals-were evaluated for periodontal disease and divided according to IR: a lean group without IR (LWIR), an obese group without IR (OWIR), and an obese group with IR (OIR). Anthropometric, metabolic, inflammatory and periodontal parameters were evaluated.

RESULTS

Periodontitis was more prevalent in obese (80.9%) than in lean subjects (41.2%), with the former group showing a risk of periodontitis sixfold that of the latter. Obese subjects as a whole displayed higher diastolic blood pressure, TNFα and hsCRP and lower HDL cholesterol than lean subjects. OIR had higher systolic blood pressure, glucose, insulin, HOMA-IR, A1c, triglycerides and number of teeth with PD ≥ 4 mm than OWIR, while other periodontal variables remained unaltered. The multivariable regression model showed that probing depth, bleeding on probing and HOMA-IR were independent predictors of number of teeth with PD ≥ 4 mm.

CONCLUSION

Our data support an association between obesity and periodontitis, and point to a central role of IR. Periodontitis tends to be more extensive in obese patients with IR.

摘要

目的

我们探讨了肥胖与牙周炎之间的关联,旨在确定胰岛素抵抗(IR)在这种关系中的可能作用。

材料与方法

共评估了 212 名受试者,110 名肥胖者和 102 名瘦弱者,评估其牙周疾病并根据 IR 进行分组:无 IR 的瘦者组(LWIR)、无 IR 的肥胖者组(OWIR)和有 IR 的肥胖者组(OIR)。评估了人体测量、代谢、炎症和牙周参数。

结果

肥胖者(80.9%)的牙周炎患病率高于瘦弱者(41.2%),前者患牙周炎的风险是后者的六倍。肥胖者的舒张压、TNFα 和 hsCRP 高于瘦弱者,而 HDL 胆固醇则较低。OIR 的收缩压、血糖、胰岛素、HOMA-IR、A1c、甘油三酯和 PD≥4mm 的牙齿数均高于 OWIR,而其他牙周变量则保持不变。多变量回归模型显示,探诊深度、探诊出血和 HOMA-IR 是 PD≥4mm 牙齿数的独立预测因子。

结论

我们的数据支持肥胖与牙周炎之间的关联,并指出 IR 的核心作用。IR 肥胖患者的牙周炎往往更广泛。

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