Suzuki Seitaro, Yoshino Koichi, Takayanagi Atsushi, Ishizuka Yoichi, Satou Ryouichi, Nara Natsuki, Kamijo Hideyuki, Sugihara Naoki
Department of Epidemiology and Public Health, Tokyo Dental College.
MinaCare Co. Ltd.
Bull Tokyo Dent Coll. 2019 Jun 21;60(2):89-96. doi: 10.2209/tdcpublication.2018-0039. Epub 2019 Apr 10.
The purpose of this cross-sectional study was to determine whether there is an association between hemoglobin A1c (HbA1c) level and the presence or absence of decayed teeth in patients with type 2 diabetes mellitus. The patients and data on their age and sex, the presence or absence of dental claims, medical history of diabetes mellitus, and workplace dental examinations were obtained from a Japanese healthcare database available for epidemiological studies. The HbA1c levels were obtained from results of the Specific Health Checkups and Specific Health Guidance tests conducted by the Japanese Ministry of Health, Labour and Welfare. Data on a total of 1,897 patients were analyzed. Patients with poorly controlled diabetes (HbA1c≥6.5, n=779) had more decayed teeth than those in whom it was well controlled (HbA1c<6.5, n=1,118). Multiple logistic regression analysis with the presence or absence of decayed teeth as a dependent variable revealed a significant association between an HbA1c level of ≥8.0 and decayed teeth (odds ratio: 1.69; 95% confidence interval, 1.24-2.29), even after adjusting for dental attendance. This suggests that a poorly controlled blood HbA1c level is a risk factor for dental caries. More thorough oral hygiene instruction and education on preventive treatment for dental caries in patients with poorly controlled diabetes are needed.
这项横断面研究的目的是确定2型糖尿病患者的糖化血红蛋白(HbA1c)水平与龋齿的有无之间是否存在关联。患者及其年龄、性别、牙科理赔情况、糖尿病病史和工作场所牙科检查的数据来自一个可用于流行病学研究的日本医疗保健数据库。HbA1c水平来自日本厚生劳动省进行的特定健康检查和特定健康指导测试结果。总共对1897名患者的数据进行了分析。糖尿病控制不佳的患者(HbA1c≥6.5,n = 779)比控制良好的患者(HbA1c<6.5,n = 1118)有更多的龋齿。以龋齿的有无作为因变量的多因素logistic回归分析显示,即使在调整了牙科就诊情况后,HbA1c水平≥8.0与龋齿之间仍存在显著关联(比值比:1.69;95%置信区间,1.24 - 2.29)。这表明血糖HbA1c水平控制不佳是龋齿的一个危险因素。对于糖尿病控制不佳的患者,需要更全面的口腔卫生指导和龋齿预防治疗教育。