State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China.
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
BMC Oral Health. 2020 Jul 11;20(1):204. doi: 10.1186/s12903-020-01180-w.
To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM).
Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA.
A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust.
There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other's incidence.
系统回顾牙周炎与 2 型糖尿病（T2DM）之间的流行病学关系。
截至 2018 年 12 月，检索了 4 个电子数据库。手工检索包括纳入研究的参考文献列表和相关期刊。纳入评估 T2DM 与牙周炎之间关系的观察性研究。使用 STATA 进行荟萃分析。
共纳入 53 项观察性研究。牙周炎患者的调整后 T2DM 患病率明显更高（OR=4.04，p=0.000），反之亦然（OR=1.58，p=0.000）。T2DM 患者的牙周状况明显更差，表现在牙周袋深 0.61mm、附着丧失多 0.89mm 以及大约多丧失 2 颗牙齿（均 p=0.000）。队列研究的结果发现，T2DM 可使牙周炎的发病风险增加 34%（p=0.002）。T2DM 患者的血糖控制可能会导致不同的牙周炎结局。严重牙周炎使 T2DM 的发病率增加 53%（p=0.000），且结果较为稳定。相比之下，轻度牙周炎对 T2DM 发病率的影响（RR=1.28，p=0.007）则不那么显著。
T2DM 与牙周炎之间存在明显的双向关系。需要进一步进行设计良好的队列研究来证实这一发现。我们的研究结果表明，牙医和内科医生都需要意识到牙周炎和 T2DM 之间的紧密联系。控制这两种疾病可能有助于预防彼此的发病。
