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牙周治疗改善 2 型糖尿病患者血脂谱的系统评价和荟萃分析。

Periodontal Therapy for Improving Lipid Profiles in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

机构信息

The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Camperdown 2006, Australia.

Westmead Applied Research Centre, Sydney Medical School, Westmead 2145, Australia.

出版信息

Int J Mol Sci. 2019 Aug 5;20(15):3826. doi: 10.3390/ijms20153826.

Abstract

Periodontitis is a chronic inflammatory disorder often seen in patients with diabetes mellitus (DM). Individuals with diabetes are at a greater risk of developing cardiovascular complications and this may be related, in part, to lipid abnormalities observed in these individuals. The objective of this systematic review is to compile the current scientific evidence of the effects of periodontal treatment on lipid profiles in patients with type 2 diabetes mellitus. Through a systematic search using MEDLINE, EMBASE, PubMed, and Web of Science, 313 articles were identified. Of these, seven clinical trials which met all inclusion criteria were chosen for analysis. Between baseline and 3-month follow-up, there was a statistically significant reduction in the levels of total cholesterol (mean differences (MD) -0.47 mmol/L (95% confidence interval (CI), -0.75, -0.18, = 0.001)), triglycerides (MD -0.20 mmol/L (95% CI -0.24, -0.16, < 0.00001)) favouring the intervention arm, and a statistically significant reduction in levels of high density lipoprotein (HDL) (MD 0.06 mmol/L (95% CI 0.03, 0.08, < 0.00001)) favouring the control arm. No significant differences were observed between baseline and 6-month follow-up levels for any lipid analysed. The heterogeneity between studies was high. This review foreshadows a potential benefit of periodontal therapy for lipid profiles in patients suffering from type 2 DM, however, well designed clinical trials using lipid profiles as primary outcome measures are warranted.

摘要

牙周炎是一种慢性炎症性疾病,常发生在糖尿病(DM)患者中。患有糖尿病的个体患心血管并发症的风险更高,这可能部分与这些个体中观察到的脂质异常有关。本系统评价的目的是汇编牙周治疗对 2 型糖尿病患者血脂谱影响的当前科学证据。通过使用 MEDLINE、EMBASE、PubMed 和 Web of Science 进行系统搜索,确定了 313 篇文章。其中,选择了符合所有纳入标准的 7 项临床试验进行分析。在基线和 3 个月随访之间,总胆固醇水平(平均差异(MD)-0.47 mmol/L(95%置信区间(CI)-0.75,-0.18, = 0.001))、甘油三酯(MD-0.20 mmol/L(95%CI-0.24,-0.16, < 0.00001))有统计学意义的降低,有利于干预组,高密度脂蛋白(HDL)水平(MD 0.06 mmol/L(95%CI 0.03,0.08, < 0.00001))有统计学意义的降低,有利于对照组。任何分析的脂质在基线和 6 个月随访之间均未观察到显著差异。研究之间的异质性很高。本综述预示着牙周治疗可能对 2 型糖尿病患者的血脂谱有益,然而,需要使用血脂谱作为主要结局指标的精心设计的临床试验。

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