非手术牙周治疗对2型糖尿病患者血糖控制、氧化应激平衡及生活质量的影响：一项随机临床试验
The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: A randomized clinical trial.
作者信息
Mizuno Hirofumi, Ekuni Daisuke, Maruyama Takayuki, Kataoka Kota, Yoneda Toshiki, Fukuhara Daiki, Sugiura Yoshio, Tomofuji Takaaki, Wada Jun, Morita Manabu
机构信息
Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama, Japan.
出版信息
PLoS One. 2017 Nov 16;12(11):e0188171. doi: 10.1371/journal.pone.0188171. eCollection 2017.
AIM
The purpose of this study was to investigate the effects of non-surgical periodontal treatment on hemoglobinA1c (HbA1c) levels, oxidative stress balance and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM) compared to no periodontal treatment (simple oral hygiene instructions only).
METHODS
The design was a 6-month, single-masked, single center, randomized clinical trial. Patients had both T2DM and chronic periodontitis. Forty participants were enrolled between April 2014 and March 2016 at the Nephrology, Diabetology and Endocrinology Department of Okayama University Hospital. The periodontal treatment group (n = 20) received non-surgical periodontal therapy, including scaling and root planing plus oral hygiene instructions, and consecutive supportive periodontal therapy at 3 and 6 months. The control group (n = 17) received only oral hygiene instructions without treatment during the experimental period. The primary study outcome was the change in HbA1c levels from baseline to 3 months. Secondary outcomes included changes in oxidative stress balance (Oxidative-INDEX), the Diabetes Therapy-Related QOL and clinical periodontal parameters from baseline to 3 months and baseline to 6 months.
RESULTS
Changes in HbA1c in the periodontal treatment group were not significantly different with those in the control group at 3 and 6 months. Systemic oxidative stress balance and QOL significantly improved in the periodontal treatment group compared to the control group at 3 months. In the subgroup analysis (moderately poor control of diabetes), the decrease in HbA1c levels in the periodontal treatment group was greater than that in the control group at 3 months but not significant.
CONCLUSIONS
In T2DM patients, non-surgical periodontal treatment improved systemic oxidative stress balance and QOL, but did not decrease HbA1c levels at 3 months follow-up.
TRIAL REGISTRATION
Current Controlled Trials UMIN-ICDR UMIN 000013278 (Registered April 1, 2014).
目的
本研究旨在调查与未进行牙周治疗（仅进行简单口腔卫生指导）相比，非手术牙周治疗对2型糖尿病（T2DM）患者糖化血红蛋白（HbA1c）水平、氧化应激平衡和生活质量（QOL）的影响。
方法
该研究为一项为期6个月的单盲、单中心随机临床试验。患者同时患有T2DM和慢性牙周炎。2014年4月至2016年3月期间，冈山大学医院肾内科、糖尿病科和内分泌科招募了40名参与者。牙周治疗组（n = 20）接受非手术牙周治疗，包括龈上洁治和根面平整以及口腔卫生指导，并在3个月和6个月时接受连续的支持性牙周治疗。对照组（n = 17）在实验期间仅接受口腔卫生指导而不进行治疗。主要研究结局是从基线到3个月时HbA1c水平的变化。次要结局包括从基线到3个月以及从基线到6个月时氧化应激平衡（氧化指数）、糖尿病治疗相关生活质量和临床牙周参数的变化。
结果
在3个月和6个月时，牙周治疗组HbA1c的变化与对照组无显著差异。与对照组相比，牙周治疗组在3个月时全身氧化应激平衡和生活质量显著改善。在亚组分析（糖尿病控制中度不佳）中，牙周治疗组在3个月时HbA1c水平的下降幅度大于对照组，但差异不显著。
结论
在T2DM患者中，非手术牙周治疗改善了全身氧化应激平衡和生活质量，但在3个月的随访中并未降低HbA1c水平。
试验注册
当前对照试验UMIN-ICDR UMIN 000013278（2014年4月1日注册）。
Zotero 插件