Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Endocrinology, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, China.
J Periodontal Res. 2022 Oct;57(5):969-976. doi: 10.1111/jre.13033. Epub 2022 Jul 18.
The aim of this study was to investigate the association between periodontitis and total serum cholesterol level in patients with type 2 diabetic nephropathy (T2DN).
Periodontitis is now recognized as the sixth complication of diabetes and can also affect other complications of diabetes, including nephropathy and coronary artery diseases. Studies have considered dyslipidemia as a risk factor for exacerbation of periodontitis.
A total of 119 T2DN patients with chronic periodontitis were included in this observational study. Participants were stratified into the Normal (serum total cholesterol <5.17 mmol/L, n = 89) and the Dyslipidemia groups (serum total cholesterol ≥5.17 mmol/L, n = 30). Participants completed a validated questionnaire that collected information on oral hygiene behaviors and knowledge of oral health and underwent a clinical oral examination. The number of remaining teeth, probing depth (PD), clinical attachment level (CAL), and bleeding index (BI) was recorded. Physical examination and laboratory tests (fasting plasma glucose, serum glycosylated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride, and high-sensitivity C-reactive protein levels) were performed.
Means of CAL and BI were significantly higher in the Dyslipidemia group compared with the Normal group. In the Dyslipidemia group, PD and percent of sites with PD ≥4 mm were positively correlated with urinary albumin/creatinine ratios; PD and percent of sites with PD ≥4 and PD ≥5 mm were positively correlated with HbA1c level; a number of remaining teeth were negatively correlated with serum LDL-C level. After adjusting for age, gender, body mass index, smoking, FPG, and serum HbA1c and triglyceride levels, BI was found to be positively associated with dyslipidemia in T2DN patients with periodontitis.
T2DN patients with chronic periodontitis had a 2.355-fold higher risk of developing dyslipidemia, implying an important relationship between periodontitis and blood lipid control among T2DN patients.
本研究旨在探讨 2 型糖尿病肾病（T2DN）患者牙周炎与总血清胆固醇水平之间的关系。
牙周炎现已被认为是糖尿病的第六大并发症，也会影响糖尿病的其他并发症，包括肾病和冠状动脉疾病。研究认为血脂异常是牙周炎恶化的一个危险因素。
本观察性研究共纳入 119 例患有慢性牙周炎的 T2DN 患者。将参与者分为正常组（血清总胆固醇<5.17mmol/L，n=89）和血脂异常组（血清总胆固醇≥5.17mmol/L，n=30）。参与者完成了一份经过验证的问卷，收集了口腔卫生行为和口腔健康知识信息，并接受了临床口腔检查。记录了剩余牙齿数量、探诊深度（PD）、临床附着水平（CAL）和出血指数（BI）。进行了体格检查和实验室检查（空腹血糖、血清糖化血红蛋白（HbA1c）、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯和高敏 C 反应蛋白水平）。
与正常组相比，血脂异常组的 CAL 和 BI 均值显著更高。在血脂异常组中，PD 和 PD≥4mm 的位点百分比与尿白蛋白/肌酐比值呈正相关；PD 和 PD≥4 和 PD≥5mm 的位点百分比与 HbA1c 水平呈正相关；剩余牙齿数量与血清 LDL-C 水平呈负相关。在校正年龄、性别、体重指数、吸烟、FPG 以及血清 HbA1c 和甘油三酯水平后，发现 BI 与 T2DN 伴牙周炎患者的血脂异常呈正相关。
患有慢性牙周炎的 2 型糖尿病肾病患者发生血脂异常的风险增加了 2.355 倍，这表明牙周炎与 2 型糖尿病肾病患者的血脂控制之间存在重要关系。
