Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia.
Department of Periodontology, Faculty of Dentistry, Universitas Jenderal Achmad Yani, Cimahi, Indonesia.
J Clin Periodontol. 2023 Aug;50(8):1042-1050. doi: 10.1111/jcpe.13809. Epub 2023 Mar 28.
To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status.
This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003-2004 and 2008-2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c).
The cross-lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow-up (β = 0.044, p = .039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p = .059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow-up was identified.
This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis.
探讨牙周状况与血糖状况之间是否存在双向的时间关系。
本纵向研究纳入了 2198 名年龄 43.4±7.7 岁的参与者,他们在日本横滨的两次时间点(2003-2004 年和 2008-2009 年)进行了牙科检查,两次检查间隔为 5 年。牙周状况通过平均探诊袋深度(PPD)和临床附着水平(CAL)进行评估。血糖状况通过空腹血糖和糖化血红蛋白(HbA1c)进行评估。
交叉滞后面板模型显示,基线时 HbA1c 对随访时平均 PPD 的影响(β=0.044,p=0.039)。空腹血糖对平均 PPD 有边缘影响(β=0.037,p=0.059)。这与空腹血糖或 HbA1c 对平均 CAL 的影响相似。然而,在相反的方向上,基线时平均 PPD 或 CAL 对随访时空腹血糖或 HbA1c 没有影响。
本研究表明血糖状况与牙周状况之间存在单向关系。然而,该研究人群主要患有轻度牙周炎。未来的研究需要调查严重牙周炎患者的牙周状况对血糖状况的影响。