Department of Stomatology, The 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Fuzhou 350025, Fujian Province, China.
Afr Health Sci. 2023 Jun;23(2):239-245. doi: 10.4314/ahs.v23i2.27.
To explore the associations of blood glucose with degree of periodontal lesions in patients with type 2 diabetes mellitus (T2DM) accompanied by chronic periodontitis (CP).
Sixty-five eligible patients were included as a T2DM+CP group, another 65 patients with T2DM alone were included as a T2DM group, and another 65 patients with CP alone were included as a CP group. Their blood glucose, insulin, Th cells and cytokine levels and periodontal indices were compared. The correlations between each index and periodontal indices were analysed. The influencing factors for T2DM accompanied by CP were explored.
The levels of fasting plasma glucose (FPG), glycated hemoglobin A1c (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR) of T2DM+CP, T2DM and CP groups followed a descending order (P<0.05). FPG, HbA1c, FINS, CD4+ Th1 cell, CD4 Th17 cell, interferon-gamma (IFN-γ) and interleukin-17 (IL-17) all had positive correlations with gingival index, bleeding index, probing depth and attachment loss in T2DM patients accompanied by CP (P<0.05). Periodontal lesions were more severe in T2DM patients accompanied by CP, and the severity was positively correlated with the levels of FPG, HbA1c, Th1, Th17, IFN-γ and IL-17.
High levels of FPG, HbA1c, IFN-γ and IL-17 are independent risk factors for T2DM accompanied by CP.
探讨 2 型糖尿病伴慢性牙周炎(CP)患者的血糖与牙周病变程度的关系。
纳入 65 例符合条件的患者为 2 型糖尿病伴 CP 组(T2DM+CP 组),另纳入 65 例单纯 2 型糖尿病患者为 2 型糖尿病组(T2DM 组),纳入 65 例单纯 CP 患者为 CP 组。比较三组患者的血糖、胰岛素、Th 细胞及细胞因子水平和牙周指数,并分析各指标与牙周指数的相关性,探讨 T2DM 伴 CP 的影响因素。
T2DM+CP、T2DM 和 CP 组的空腹血糖(FPG)、糖化血红蛋白 A1c(HbA1c)、空腹胰岛素(FINS)和稳态模型评估胰岛素抵抗(HOMA-IR)水平依次降低(P<0.05)。FPG、HbA1c、FINS、CD4+Th1 细胞、CD4+Th17 细胞、干扰素-γ(IFN-γ)和白细胞介素-17(IL-17)与 T2DM 伴 CP 患者的牙龈指数、出血指数、探诊深度和附着丧失均呈正相关(P<0.05)。T2DM 伴 CP 患者牙周病变更严重,且严重程度与 FPG、HbA1c、Th1、Th17、IFN-γ 和 IL-17 水平呈正相关。
FPG、HbA1c、IFN-γ 和 IL-17 水平升高是 T2DM 伴 CP 的独立危险因素。