Yokoyama Hiroki, Yamamoto Tatsuo, Tanaka Michio, Kudo Chieko, Hidaka Koichi, Kuribayashi Nobuichi, Minabe Masato
Jiyugaoka Medical Clinic, Internal Medicine, West 6, South 6-4-3, Obihiro, 080-0016 Japan.
2Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan.
Diabetol Int. 2018 Dec 12;10(4):250-259. doi: 10.1007/s13340-018-0388-5. eCollection 2019 Oct.
Diabetes and periodontitis may increase risk of cardiovascular disease. Whether albuminuria, C-reactive protein (CRP), and socioeconomic factors, known as cardiovascular risks in subjects with poorly controlled diabetes, are independently associated with periodontal status in well-controlled diabetes remains to be elucidated. In 503 subjects with type 2 diabetes, the cross-sectional associations of clinical and socioeconomic factors with periodontal parameters were investigated. Periodontal parameters on all teeth included the probing pocket depth at 6 sites per tooth, bleeding on probing, the plaque score, tooth mobility, and the number of teeth. The subjects had a mean HbA1c value of 6.85% and a median CRP value of 0.06 mg/dL, and 27.9% of the subjects had albuminuria. Albuminuria and CRP values had significant associations with several periodontal parameters, whereas other variables including HbA1c did not. Subjects with albuminuria had significantly higher HbA1c, CRP, and % sites of pocket depth ≥ 4 mm than subjects with normoalbuminuria; additionally, those with high CRP (≥ median) had significantly higher body mass index, HbA1c, % sites of pocket depth ≥ 4 mm, and plaque score than those with low CRP. In multiple linear regression analysis, albuminuria, CRP, education, smoking, and dental attendance exhibited significant associations with periodontal parameters, independent of the effect of age, sex, body mass index, and diabetes therapy. Albuminuria, CRP, education, smoking, and dental attendance were independently associated with periodontal parameters even in subjects with a mean of HbA1c of 6.85%, implying the importance of these factors for the prevention of cardiovascular disease.
糖尿病和牙周炎可能会增加心血管疾病的风险。在糖尿病控制不佳的患者中,蛋白尿、C反应蛋白(CRP)以及社会经济因素被视为心血管疾病风险因素,而在糖尿病控制良好的患者中,这些因素是否与牙周状况独立相关仍有待阐明。在503名2型糖尿病患者中,研究了临床和社会经济因素与牙周参数的横断面关联。所有牙齿的牙周参数包括每颗牙齿6个位点的探诊深度、探诊出血、菌斑评分、牙齿松动度以及牙齿数量。这些患者的糖化血红蛋白(HbA1c)平均值为6.85%,CRP中位数为0.06mg/dL,27.9%的患者有蛋白尿。蛋白尿和CRP值与多个牙周参数存在显著关联,而包括HbA1c在内的其他变量则没有。与正常蛋白尿患者相比,有蛋白尿的患者HbA1c、CRP以及探诊深度≥4mm的位点百分比显著更高;此外,CRP高(≥中位数)的患者比CRP低的患者体重指数、HbA1c、探诊深度≥4mm的位点百分比以及菌斑评分显著更高。在多元线性回归分析中,蛋白尿、CRP、教育程度、吸烟以及看牙就诊情况与牙周参数存在显著关联,不受年龄、性别、体重指数和糖尿病治疗的影响。即使在HbA1c平均值为6.85%的患者中,蛋白尿、CRP、教育程度、吸烟以及看牙就诊情况也与牙周参数独立相关,这表明这些因素对于预防心血管疾病具有重要意义。