Department of Dental Clinic, Division of Periodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Internal Medicine and Endocrine Unit, School of Medicine, Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Professor Rodolpho Paulo Rocco Street, 255. 9th floor-Endocrinology Unit Rio de Janeiro, Rio de Janeiro, RJ, 21941-913, Brazil.
J Endocrinol Invest. 2021 Nov;44(11):2455-2463. doi: 10.1007/s40618-021-01557-w. Epub 2021 Mar 31.
There are no data regarding periodontal derangements in patients with adrenal incidentalomas (AI). We assessed the frequency and severity of periodontitis in patients with AI [non-functioning adrenal incidentaloma (NFAI) and possible autonomous cortisol secretion (ACS)] and compared with individuals with normal adrenal.
A cross-sectional study evaluated thirty-five individuals with AI and 26 controls. NFAI and possible ACS diagnosis was based on the current guidelines: NFAI [cortisol levels after 1 mg dexamethasone suppression test (1 mg-DST) ≤ 1.8 µg/dL (≤ 50 nmol/L)]; possible ACS [cortisol levels after 1 mg-DST 1.9-5.0 µg/dL (51-138 nmol/L)]. Sociodemographic data were collected, and a full-mouth periodontal evaluation was performed.
There was no significant difference between groups regarding age, sex, income, ethnicity, education level, smoking, body mass index, dysglycemia, and arterial hypertension. Patients with AI exhibited worse periodontal conditions than controls for the following periodontal clinical parameters: mean percentage of probing pocket depth (PPD) and clinical attachment level (CAL) ≥ 5 mm (p < 0.001 and p = 0.006, respectively). Patients with NFAI and possible ACS showed higher gingival bleeding index (p = 0.014), bleeding on probing (p < 0.001), and CAL (p < 0.001) means compared to controls. The frequencies of periodontitis were 72.7% in patients with NFAI, 84.6% in possible ACS, and 30.8% in controls (p = 0.001). Periodontitis was more severe in patients with possible ACS than NFAI and controls. Patients with NFAI and possible ACS exhibited odds ratio for periodontitis of 4.9 (p = 0.016) and 8.6 (p = 0.02), respectively.
Patients with AI have higher frequency and severity of periodontitis than controls. The presence of AI was an independent predictive factor for periodontitis.
目前尚无关于肾上腺意外瘤（AI）患者牙周紊乱的数据。我们评估了 AI 患者（无功能性肾上腺意外瘤（NFAI）和可能自主皮质醇分泌（ACS））的牙周炎频率和严重程度，并与正常肾上腺的个体进行了比较。
一项横断面研究评估了 35 名 AI 患者和 26 名对照者。NFAI 和可能 ACS 的诊断基于当前指南：NFAI [1 毫克地塞米松抑制试验（1 毫克-DST）后皮质醇水平≤1.8μg/dL（≤50nmol/L）]；可能 ACS [1 毫克-DST 后皮质醇水平 1.9-5.0μg/dL（51-138nmol/L）]。收集社会人口统计学数据，并进行全口牙周评估。
两组在年龄、性别、收入、种族、教育水平、吸烟、体重指数、糖代谢异常和动脉高血压方面无显著差异。AI 患者的牙周临床参数（探诊深度[PPD]和临床附着丧失[CAL]均值≥5mm）比对照组差（p<0.001 和 p=0.006）。NFAI 和可能 ACS 患者的牙龈出血指数（p=0.014）、探诊出血（p<0.001）和 CAL（p<0.001）均值均高于对照组。NFAI 患者的牙周炎发生率为 72.7%，可能 ACS 为 84.6%，对照组为 30.8%（p=0.001）。可能 ACS 患者的牙周炎比 NFAI 和对照组更严重。NFAI 和可能 ACS 患者患牙周炎的比值比分别为 4.9（p=0.016）和 8.6（p=0.02）。
AI 患者的牙周炎发生率和严重程度高于对照组。AI 的存在是牙周炎的独立预测因素。
