Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
J Clin Periodontol. 2018 Jun;45(6):650-662. doi: 10.1111/jcpe.12839. Epub 2018 May 10.
Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes.
The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis was extracted or if possible calculated.
From the 803 titles and abstracts that came out of the search, 27 papers met the initial criteria. Prevalence of diabetes was 13.1% among subjects with periodontitis and 9.6% among subjects without periodontitis. Based on subanalysis, for subjects with periodontitis, the prevalence of diabetes was 6.2% when diabetes was self-reported, compared to 17.3% when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries (17.2%, n = 18,002) and the lowest in studies describing populations from Europe (4.3%, n = 7,858). The overall odds ratio for patients with diabetes to be among subjects with periodontitis as compared to those without periodontitis was 2.27 (95% CI [1.90;2.72]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias.
The overall prevalence and odds of having diabetes are higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe.
糖尿病和牙周炎是复杂的慢性病，两者之间存在已确立的双向关系。本系统评价评估了经专业诊断患有牙周炎的受试者中糖尿病的患病率和发病风险。
检索 MEDLINE-PubMed、CENTRAL 和 EMBASE 数据库。提取或尽可能计算患有牙周炎的受试者中糖尿病的患病率。
从搜索中得出的 803 个标题和摘要中，有 27 篇文章符合初始标准。患有牙周炎的受试者中糖尿病的患病率为 13.1%，而无牙周炎的受试者中糖尿病的患病率为 9.6%。基于亚分析，对于患有牙周炎的受试者，如果糖尿病是自我报告的，则糖尿病的患病率为 6.2%，而如果糖尿病是临床评估的，则为 17.3%。患有牙周炎的受试者中糖尿病的患病率最高见于来自亚洲国家的研究（17.2%，n=18002），而患病率最低见于描述欧洲人群的研究（4.3%，n=7858）。患有糖尿病的患者与无牙周炎的患者相比，患有牙周炎的患者的总体发病风险比为 2.27（95%CI[1.90；2.72]）。由于牙周炎的定义存在差异、自我报告和临床评估的糖尿病相结合、纳入研究中缺乏对糖尿病控制的混杂因素，因此存在估计偏倚。
与无牙周炎的人群相比，牙周炎人群中糖尿病的总体患病率和发病风险更高。与经临床评估的糖尿病相比，自我报告的糖尿病会低估患病率。观察到地域差异：患有牙周炎的受试者中糖尿病的最高患病率见于亚洲进行的研究，而最低见于欧洲起源的研究。
