Kim Su Hwan, Lee Jihye, Kim Won Kyung, Lee Young Kyoo, Kim Young Sung
Department of Periodontics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Seoul Jihye Dental Clinic, Yongin, Korea.
J Periodontal Implant Sci. 2021 Apr;51(2):114-123. doi: 10.5051/jpis.2005620281.
This retrospective cohort study aimed to assess the effect of nonsurgical periodontal therapy on glycated hemoglobin (HbA1c) levels in patients with both type 2 diabetes and chronic periodontitis.
The intervention cohort (IC) comprised 133 patients with type 2 diabetes who received nonsurgical periodontal treatment, while the matching cohort (MC) included 4787 patients with type 2 diabetes who visited the Department of Endocrinology and Metabolism of Asan Medical Center. The patients in each cohort were divided into 3 groups according to their baseline HbA1c level: subgroup 1, HbA1c <7%; subgroup 2, 7%≤ HbA1c <9%; and subgroup 3, HbA1c ≥9%. Changes in HbA1c levels from baseline to 6 and 12 months were analyzed. In addition, the association between changes in HbA1c levels and the number of periodontal maintenance visits was investigated.
There were no statistically significant changes in HbA1c levels in the IC and MC or their subgroups when evaluated with repeated-measures analysis of variance. However, the IC showed maintenance of baseline HbA1c levels, while the MC had a trend for HbA1c levels to steadily increase as shown by pairwise comparisons (baseline to 6 months and baseline to 12 months). IC subgroup 1 also maintained steady HbA1c levels from 6 months to 12 months, whereas MC subgroup 1 presented a steady increase during the same period. The number of periodontal maintenance visits had no association with changes in HbA1c levels during the 1-year study duration.
For patients with both type 2 diabetes and periodontitis, nonsurgical periodontal treatment and periodontal maintenance may help to control HbA1c levels.
本回顾性队列研究旨在评估非手术牙周治疗对2型糖尿病合并慢性牙周炎患者糖化血红蛋白(HbA1c)水平的影响。
干预队列(IC)由133例接受非手术牙周治疗的2型糖尿病患者组成,而匹配队列(MC)包括4787例到峨山医学中心内分泌与代谢科就诊的2型糖尿病患者。每个队列中的患者根据其基线HbA1c水平分为3组:亚组1,HbA1c<7%;亚组2,7%≤HbA1c<9%;亚组3,HbA1c≥9%。分析从基线到6个月和12个月时HbA1c水平的变化。此外,还研究了HbA1c水平变化与牙周维护就诊次数之间的关联。
采用重复测量方差分析评估时,IC和MC及其亚组的HbA1c水平均无统计学上的显著变化。然而,IC显示基线HbA1c水平保持稳定,而MC的HbA1c水平有稳步上升的趋势,如两两比较所示(基线到6个月和基线到12个月)。IC亚组1在6个月至12个月期间也保持HbA1c水平稳定,而MC亚组1在同一时期呈稳步上升。在为期1年的研究期间,牙周维护就诊次数与HbA1c水平变化无关。
对于2型糖尿病合并牙周炎的患者,非手术牙周治疗和牙周维护可能有助于控制HbA1c水平。