de Miguel-Infante Ana, Martinez-Huedo Maria A, Mora-Zamorano Eduardo, Hernández-Barrera Valentín, Jiménez-Trujillo Isabel, de Burgos-Lunar Carmen, Cardenas Valladolid Juan, Jiménez-García Rodrigo, Lopez-de-Andrés Ana
Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Preventive Medicine and Public Health Teaching and Research Unit, La Paz Hospital University, Madrid, Spain.
Int J Clin Pract. 2018 Nov 16:e13294. doi: 10.1111/ijcp.13294.
We sought (a) to assess the association between periodontal disease and diabetes, controlling for socio-demographic characteristics, comorbidities, oral health status and lifestyle variables; (b) to identify which of these variables are independently associated with periodontal disease among diabetes sufferers.
We conducted a case-control study using data from the National/European Health Interview Surveys, conducted from 2003 to 2014 in Spain. We included 65 295 subjects ≥40 years. Diabetes status was self-reported. One non-diabetic control was matched by the year-of-survey, age and sex for each diabetic patient. The presence of periodontal disease was defined using the answer "my teeth bleed spontaneously or while brushing" or/and "my teeth move" to the following question: "Do you suffer of any of these dental and oral disorders or disease?". Independent variables included demographic, socio-economic and healthcare related variables, oral health status and comorbidities.
The prevalence of periodontal disease was higher among those suffering from diabetes than their non-diabetes controls (23.8% vs 19.5%; P < 0.001). Adjusted OR of periodontal disease for subjects with diabetes was 1.22 (95% CI; 1.03-1.45). Among diabetes sufferers, missing teeth status (OR 2.08, 95% CI; 1.70-2.53), suffering osteoporosis (OR 1.41, 95% CI; 1.07-1.63) and suffering depression (OR 1.39, 95% CI; 1.12-1.71) were positively associated with higher risk of periodontal disease. Older ages, using private insurance and university education level were associated with lower rates of periodontitis.
Diabetes subjects have an increased likelihood of periodontal disease. Dentists and physicians should increase their awareness with their diabetic patients, especially those with lower educational level, with missing teeth, osteoporosis and depression.
（a）我们试图评估牙周疾病与糖尿病之间的关联，同时控制社会人口统计学特征、合并症、口腔健康状况和生活方式变量；（b）确定在糖尿病患者中，这些变量中的哪些与牙周疾病独立相关。
我们利用2003年至2014年在西班牙进行的国家/欧洲健康访谈调查的数据开展了一项病例对照研究。我们纳入了65295名年龄≥40岁的受试者。糖尿病状态通过自我报告获得。为每名糖尿病患者匹配一名非糖尿病对照，匹配因素包括调查年份、年龄和性别。牙周疾病的存在通过对以下问题回答“我的牙齿会自发出血或刷牙时出血”或/和“我的牙齿松动”来定义：“你是否患有以下任何牙齿和口腔疾病？”。自变量包括人口统计学、社会经济和医疗保健相关变量、口腔健康状况和合并症。
糖尿病患者中牙周疾病的患病率高于非糖尿病对照（23.8%对19.5%；P<0.001）。糖尿病患者患牙周疾病的校正比值比为1.22（95%置信区间；1.03 - 1.45）。在糖尿病患者中，缺牙状态（比值比2.08，95%置信区间；1.70 - 2.53）、患有骨质疏松症（比值比1.41，95%置信区间；1.07 - 1.63）和患有抑郁症（比值比1.39，95%置信区间；1.12 - 1.71）与牙周疾病的较高风险呈正相关。年龄较大、使用私人保险和大学教育水平与牙周炎发病率较低相关。
糖尿病患者患牙周疾病的可能性增加。牙医和医生应提高对糖尿病患者的认识，尤其是那些教育水平较低、有缺牙、骨质疏松症和抑郁症的患者。
