Adhenkavil Radhakrishnan Raji, Joseph Vadakkekuttical Rosamma, Radhakrishnan Chandni
Department of Periodontics, Government Dental College, Kerala University of Health Sciences, Calicut, Kerala, India.
Department of Medicine, Government Medical College, Calicut, Kerala, India.
J Periodontol. 2022 May;93(5):687-696. doi: 10.1002/JPER.21-0174. Epub 2021 Oct 4.
The association between diabetic neuropathy with and without diabetic foot and periodontitis remains unaddressed in the literature. The present study was conducted to evaluate the frequency of patients with periodontitis and its severity, and to correlate clinical attachment loss (AL) and periodontal inflamed surface area (PISA) with HbA1c in Type 2 Diabetic Neuropathy (T2DN) patients with and without diabetic foot.
In this cross-sectional study 310 patients with type 2 diabetic neuropathy (T2DN) were randomly selected, and the study comprised of 120 patients with T2DN with diabetic foot and 155 patients with T2DN without diabetic foot. All patients were assessed for periodontal parameters (bleeding on probing, probing depth, clinical AL, oral hygiene index-simplified), plaque index, and PISA) and systemic parameters (HbA1c, fasting blood glucose, post prandial blood glucose, urinary albumin creatine ratio, erythrocyte sedimentation rate, and high-sensitivity C-reactive protein).Unpaired t-test and Chi-Square test were used to analyze quantitative data and qualitative data, respectively.
The frequency of patients with periodontitis in patients with T2DN with and without diabetic foot was 91.7% and 88.4%, respectively. The severity of periodontitis, PISA, and clinical AL were higher in the diabetic foot group. Clinical AL and PISA were significantly related with HbA1c in patients with T2DN with and without diabetic foot.
Percentage of patients with periodontitis and the severity of periodontal destruction were high in type 2 diabetic neuropathy with diabetic foot. A significant correlation of PISA, clinical AL with glycemic status was found in patients with T2DN with and without diabetic foot.
糖尿病性神经病变伴或不伴糖尿病足与牙周炎之间的关联在文献中尚未得到探讨。本研究旨在评估牙周炎患者的发生率及其严重程度，并将2型糖尿病性神经病变（T2DN）伴或不伴糖尿病足患者的临床附着丧失（AL）和牙周炎症表面积（PISA）与糖化血红蛋白（HbA1c）进行相关性分析。
在这项横断面研究中，随机选取310例2型糖尿病性神经病变（T2DN）患者，其中包括120例伴有糖尿病足的T2DN患者和155例不伴有糖尿病足的T2DN患者。对所有患者进行牙周参数（探诊出血、探诊深度、临床AL、简化口腔卫生指数）、菌斑指数和PISA评估，以及全身参数（HbA1c、空腹血糖、餐后血糖、尿白蛋白肌酐比值、红细胞沉降率和高敏C反应蛋白）评估。分别采用非配对t检验和卡方检验分析定量数据和定性数据。
伴有和不伴有糖尿病足的T2DN患者中，牙周炎患者的发生率分别为91.7%和8S.4%。糖尿病足组的牙周炎严重程度、PISA和临床AL更高。伴有和不伴有糖尿病足的T2DN患者中，临床AL和PISA均与HbA1c显著相关。
伴有糖尿病足的2型糖尿病性神经病变患者中，牙周炎患者的比例和牙周破坏的严重程度较高。伴有和不伴有糖尿病足的T2DN患者中，均发现PISA、临床AL与血糖状态存在显著相关性。
