Wu Hui-Qun, Wei Xiao, Yao Jin-Yi, Qi Jian-Yan, Xie Hui-Min, Sang Ai-Min, Jiang Kui
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China.
Int J Ophthalmol. 2021 Jan 18;14(1):141-147. doi: 10.18240/ijo.2021.01.20. eCollection 2021.
To verify the association between retinopathy, nephropathy, and periodontitis in type 2 diabetic (T2D) patients.
Several electronic databases were available for our comprehensive search including China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang, Web of Science, ScienceDirect and PubMed and were queried for relevant citations (updated to Mar. 2019). RevMan was utilized to perform Meta analysis and publication bias detection. After evaluation of the methodological quality of included studies, a fixed or random effect model was utilized to analyze data from included studies.
A total of eight articles were finally included in this Meta analysis. In all 3987 subjects, there were 1207 T2D patients accompanying with microvascular complications and 1734 patients with periodontitis as well. The Meta forest plot presented little heterogeneity of the eight studies (<0.00001, =89%). The total effect demonstrated periodontitis was associated with overall microvascular complications (OR: 1.96, 95%CI: 1.67-2.30, =8.25, <0.00001). Subgroup investigations among the studies in Asian (OR: 2.33, 95%CI: 1.91-2.85) and North American (OR: 1.42, 95%CI: 1.08-1.86) populations confirmed the existed association between retinopathy, nephropathy, and periodontitis. While the strength of such associations between periodontitis and diabetic microvascular complications were more obvious in the Asians than North Americans. All the results indicated that periodontitis was associated with diabetic retinopathy (OR: 3.77, 95%CI: 2.71-5.24), diabetic nephropathy (OR: 1.55, 95%CI: 1.24-1.94) in T2D patients.
The periodontitis is associated with diabetic retinopathy, diabetic nephropathy among T2D patients and further large sample size clinical trials are in need to confirm the findings.
验证2型糖尿病（T2D）患者视网膜病变、肾病和牙周炎之间的关联。
通过多个电子数据库进行全面检索，包括中国知网（CNKI）、维普资讯（VIP）、万方、Web of Science、ScienceDirect和PubMed，并查询相关文献（更新至2019年3月）。使用RevMan进行Meta分析和发表偏倚检测。在评估纳入研究的方法学质量后，采用固定效应或随机效应模型分析纳入研究的数据资料。
本Meta分析最终共纳入8篇文章纳入3987名受试者，其中1207名T2D患者伴有微血管并发症，1734名患者患有牙周炎Meta森林图显示8项研究的异质性较小（I²<0.00001，P = 89%）。总体效应表明牙周炎与总体微血管并发症相关（OR：1.96，95%CI：1.67 - 2.30，Z = 8.25，P<0.00001）。对亚洲人群（OR：2.33，95%CI：1.91 - 2.85）和北美人群（OR：1.42，95%CI：1.08 - 1.86）研究的亚组调查证实视网膜病变、肾病和牙周炎之间存在关联。而牙周炎与糖尿病微血管并发症之间这种关联强度在亚洲人中比北美人群中更为明显。所有结果表明，牙周炎与T2D患者的糖尿病视网膜病变（OR：3.77，95%CI：2.71 - 5.24）、糖尿病肾病（OR：1.55，95%CI：1.24 - 1.94）相关。
牙周炎与T2D患者的糖尿病视网膜病变、糖尿病肾病相关，需要进一步开展大样本量的临床试验来证实这一发现。
