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2型糖尿病合并慢性牙周炎患者微量白蛋白尿状况的比较:一项横断面研究。

Comparison of Microalbuminuria Status in Type 2 Diabetes Mellitus Patients With Chronic Periodontitis: A Cross-Sectional Study.

作者信息

Nair Deepa K, Shanthi B, Nandu Baby P

机构信息

Biochemistry, Bharath Institute of Higher Education and Research, Tambaram, IND.

Biochemistry, Sree Balaji Medical College and Hospital, Chennai, IND.

出版信息

Cureus. 2022 Jul 28;14(7):e27383. doi: 10.7759/cureus.27383. eCollection 2022 Jul.

Abstract

Background Diabetes has increased the risk for various other ailments in various organs of the body. This can be contributing to periodontitis also as it is the sixth complication related to diabetes mellitus. There is a bidirectional relationship between both. Given the high global prevalence of type-2 diabetes mellitus (T2DM) with periodontitis, it is of great importance to determine the link between periodontitis and microalbuminuria in T2DM patients, which shows early renal disease. Methodology In the present study, a total of 500 patients having T2DM were assessed for periodontitis using Community Periodontal Index (CPI). Anthropometric and biochemical measurements were obtained. Blood samples were estimated for glycemic control tests such as fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and lipid profile. The subjects who participated in the study were categorized into three groups depending on the albuminuria level. The data were tabulated and analyzed using SPSS Statistics software (IBM Corp., Armonk, USA). Results Out of 500 T2DM subjects, 342 subjects had periodontitis. A statistically significant difference was found in FPG, HbA1c, total cholesterol (TC), triglycerides, and low-density lipoprotein (LDL) between subjects with periodontitis and without periodontitis using a t-test (p = <0.001). The prevalence of normoalbuminuria, micro-, and macroalbuminuria among periodontitis patients was 24.6%, 72.8%, and 2.6% respectively, and the Chi-square analysis revealed that was highly significant. In terms of albuminuria, one-way analysis of variance (ANOVA) revealed statistically significant differences among the periodontitis subjects for the following variables: inputs such as the number of teeth, diabetes mellitus (DM) duration, the level of LDL, and also the depth of the pocket. Intergroup comparison of variables among subjects with albuminuria using the statistical test of Tukey Post Hoc found that there is a significant difference between normoalbuminuria and microalbuminuria. CPI score, tooth mobility, smoking, education level, family income, tooth brushing duration, along with the use of other dental hygiene aids was also found to be statistically significant among subjects with periodontitis. Conclusion The study concluded that T2DM patients had a higher incidence of microalbuminuria among individuals with periodontitis. These subjects also had significantly higher HbA1c and FPG levels than subjects with normoalbuminuria. In addition, subjects with periodontitis exhibited a significant reduction in the total teeth numbers present in the case of albuminuria. The longitudinal correlation between DM, microalbuminuria, and periodontitis could be further investigated in detail to explore possible pathways.

摘要

背景 糖尿病增加了身体各个器官患其他各种疾病的风险。这也可能导致牙周炎,因为它是与糖尿病相关的第六种并发症。两者之间存在双向关系。鉴于2型糖尿病(T2DM)与牙周炎在全球的高患病率,确定T2DM患者中牙周炎与微量白蛋白尿之间的联系非常重要,微量白蛋白尿表明早期肾病。

方法 在本研究中,使用社区牙周指数(CPI)对总共500名T2DM患者进行了牙周炎评估。进行了人体测量和生化测量。采集血样进行血糖控制测试,如空腹血糖(FPG)、糖化血红蛋白(HbA1c)和血脂谱检测。根据白蛋白尿水平,将参与研究的受试者分为三组。使用SPSS统计软件(美国纽约州阿蒙克市IBM公司)将数据制成表格并进行分析。

结果 在500名T2DM受试者中,342名受试者患有牙周炎。使用t检验发现,患有牙周炎和未患有牙周炎的受试者在FPG、HbA1c、总胆固醇(TC)、甘油三酯和低密度脂蛋白(LDL)方面存在统计学上的显著差异(p = <0.001)。牙周炎患者中正常白蛋白尿、微量白蛋白尿和大量白蛋白尿的患病率分别为24.6%、72.8%和2.6%,卡方分析显示差异非常显著。在白蛋白尿方面,单因素方差分析(ANOVA)显示,牙周炎受试者在以下变量方面存在统计学上的显著差异:牙齿数量、糖尿病(DM)病程、LDL水平以及牙周袋深度等指标。使用Tukey事后检验的统计检验对白蛋白尿受试者之间的变量进行组间比较发现,正常白蛋白尿和微量白蛋白尿之间存在显著差异。在患有牙周炎的受试者中,CPI评分、牙齿松动度、吸烟、教育水平、家庭收入、刷牙时间以及使用其他口腔卫生辅助用品也具有统计学意义。

结论 该研究得出结论,T2DM患者中,患有牙周炎的个体微量白蛋白尿的发生率更高。这些受试者的HbA1c和FPG水平也明显高于正常白蛋白尿的受试者。此外,患有牙周炎的受试者在白蛋白尿情况下牙齿总数显著减少。可以进一步详细研究DM、微量白蛋白尿和牙周炎之间的纵向相关性,以探索可能的途径。

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