Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Poznan, Poland.
Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
Oral Dis. 2018 Oct;24(7):1336-1342. doi: 10.1111/odi.12889. Epub 2018 May 29.
Periodontal disease may develop on the background of microvascular complications of diabetes. However, some modifying factors, such as tobacco smoking, should be taken into consideration when assessing risk of development of chronic complications. The aim of the study was the clinical assessment of the periodontal status in patients with type 1 diabetes according to tobacco smoking.
A total of 362 subjects aged 29 (IQR 22-35) years, type 1 diabetes duration 12 (8-18) years, hemoglobin A1c, HbA1c 8.0 (7.2-9.1)% were included. We used Gingival Index, Approximal Plaque Index, and Sulcus Bleeding Index to assess periodontal health. Patients were divided into two subgroups according to current cigarette smoking.
No differences in age, diabetes duration, and chronic complications were found between subgroups. A better metabolic control of diabetes expressed by lower HbA1c (p = 0.00001) and triglyceride levels (p = 0.004) was shown in nonsmokers. Smokers presented significantly lower gingival bleeding, p = 0.009. HbA1c correlated with API in study group (Rs = 0.16; p = 0.002) and in nonsmokers subgroup (Rs = 0.2;p = 0.004), however, not in smoker's subgroup. In multivariable regression analysis, smoking cigarettes (β = -0.26; p = 0.0002), hs-CRP (β = 0.15; p = 0.03) and age (β = -0.19; p = 0.007) occurred to be independent predictors of SBI after adjustment for confounding variables (R = 0.13; p = 0.001).
Patients with type 1 diabetes smoking cigarettes presented lower gingival sulcus bleeding and worse metabolic control of diabetes than nonsmoking patients.
牙周病可能在糖尿病微血管并发症的背景下发展。然而，在评估慢性并发症发生风险时，应考虑到一些修饰因子，如吸烟。本研究的目的是根据吸烟状况评估 1 型糖尿病患者的牙周状况。
共纳入 362 名年龄为 29 岁（IQR 22-35）岁，1 型糖尿病病程 12 年（8-18）年，糖化血红蛋白（HbA1c）为 8.0（7.2-9.1）%的患者。我们使用牙龈指数、近中菌斑指数和龈沟出血指数来评估牙周健康。根据当前吸烟情况，将患者分为两组。
在年龄、糖尿病病程和慢性并发症方面，两组间无差异。不吸烟者的糖尿病代谢控制更好，HbA1c（p=0.00001）和甘油三酯水平（p=0.004）较低。吸烟者的牙龈出血明显较少（p=0.009）。HbA1c 与研究组（Rs=0.16；p=0.002）和不吸烟者亚组（Rs=0.2；p=0.004）中的 API 相关，但在吸烟者亚组中不相关。在多变量回归分析中，调整混杂变量后，吸烟（β=-0.26；p=0.0002）、高敏 C 反应蛋白（hs-CRP）（β=0.15；p=0.03）和年龄（β=-0.19；p=0.007）为 SBI 的独立预测因子（R ²=0.13；p=0.001）。
与不吸烟的患者相比，1 型糖尿病吸烟患者的牙龈沟出血较少，糖尿病代谢控制较差。
