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2 型糖尿病伴牙周炎患者的炎症状态和血糖控制水平:一项随机临床试验。

Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial.

机构信息

Department of Basic Medical Sciences, Neurosciences and Sense Organs, "Aldo Moro" University of Bari, 70121 Bari, Italy.

Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, 66100 Chieti, Italy.

出版信息

Int J Environ Res Public Health. 2021 Mar 15;18(6):3018. doi: 10.3390/ijerph18063018.

Abstract

BACKGROUND

Based on the holistic approach to prevention diabetic disease, the role of periodontal inflammation in type 2 diabetes mellitus (T2DM) is under intensive scrutiny. Data from clinical trials have shown benefit from a periodontal therapy in providing patients with type 2 diabetes improvement despite relatively disappointing long-terms response rates. The aim of this study was to investigate the short-term glycemic control level and systemic inflammatory status after periodontal therapy.

METHODS

This was a randomized trial with a 6-months follow-up. Participants aged 56.4 ± 7.9 years with diagnosed type 2 diabetes and periodontitis were enrolled. Among the 187 type 2 diabetic patients, 93 were randomly assigned to receive non-surgical periodontal treatment immediately and 94 to receive the delayed treatment. Within and between groups comparison was done during the study period, and the differences between groups were assessed.

RESULTS

The difference between HbA1c values at baseline ( = 7.7) and 6 months after non-surgical periodontal treatment ( = 7.2) was statistically significant, = 3174.5, = 0.012, = 0.187. However, although technically a positive correlation, the relationship between the glycated hemoglobin value and periodontal variables was weak. The differences between both the groups over 6 months were not statistically considerable, failing to reach statistical significance. At 6 months the difference between groups about the C-reactive protein (CRP) levels was statistically significant, =1839.5, = 0, = 0.472, with a lower concentration for the intervention group. Furthermore, the intervention group showed a statistically significant difference between baseline and 6 months evaluation ( = 2606.5, = 0, = 0.308).

CONCLUSIONS

The periodontal intervention potentially may allow individuals with type 2 diabetes to improve glycemic control and CRP concentrations, and diabetes alters the periodontal status.

摘要

背景

基于糖尿病预防的整体方法,牙周炎在 2 型糖尿病(T2DM)中的作用受到了广泛关注。临床试验数据表明,尽管长期缓解率相对较低,但牙周治疗对 2 型糖尿病患者有益。本研究旨在探讨牙周治疗后短期血糖控制水平和全身炎症状态。

方法

这是一项为期 6 个月随访的随机试验。共纳入 187 例年龄为 56.4 ± 7.9 岁、诊断为 2 型糖尿病和牙周炎的患者。其中 93 例随机分为即刻接受非手术牙周治疗组,94 例为延迟治疗组。在研究期间进行了组内和组间比较,并评估了组间差异。

结果

非手术牙周治疗后 6 个月时,HbA1c 值(基线为 7.7)与 6 个月时的差异具有统计学意义, = 3174.5, = 0.012, = 0.187。然而,尽管糖化血红蛋白值与牙周变量之间存在技术上的正相关,但相关性较弱。两组在 6 个月时的差异无统计学意义,未达到统计学显著性。6 个月时,两组间 C 反应蛋白(CRP)水平的差异具有统计学意义, =1839.5, = 0, = 0.472,干预组浓度较低。此外,干预组在基线和 6 个月评估时的差异具有统计学意义( = 2606.5, = 0, = 0.308)。

结论

牙周干预可能使 2 型糖尿病患者的血糖控制和 CRP 浓度得到改善,且糖尿病改变了牙周状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaed/7998112/8e26e04625be/ijerph-18-03018-g001.jpg

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