Andriankaja Oelisoa M, Joshipura Kaumudi J, Levine Michael A, Ramirez-Vick Margarita, Rivas-Agosto Julio A, Duconge Jorge S, Graves Dana T
Department of Oral Health Practice, College of Dentistry, University of Kentucky, 770 Rose Street, Dental Science Building, Office D-106B3, Lexington, KY 40536, USA.
Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus University of Puerto Rico, San Juan, Puerto Rico.
Ther Adv Chronic Dis. 2023 Dec 25;14:20406223231213252. doi: 10.1177/20406223231213252. eCollection 2023.
Recent studies suggest that lipid-lowering agents (LLA) may reduce chronic periodontitis, but it is unknown whether this benefit extends to people with type 2 diabetes (T2D).
We assessed the association between LLA use and periodontitis in Hispanic adults with T2D.
This was a cross-sectional observational study.
We assessed the association of LLA use and periodontal parameters in 253 Puerto Ricans 40-65 years with T2D who participated in the Lipid-Lowering agents use in Periodontitis and Diabetes Study study. Participants were classified as (a) none- or <1 year, (b) 1-4 years, or (c) >4 years. The primary outcome consists of a tertile percent of sites with probing pocket depth (PPD) ⩾ 4 mm and the secondary outcome includes tertiles of percent sites with clinical attachment loss (CAL) ⩾ 4 mm. Multinomial logistic regression models adjusted for age, gender, smoking status, education, waist circumference, glycosylated hemoglobin A1C (HbA1c), bleeding on probing, examiner, and anti-inflammatory agents were used to estimate the association.
LLA (92.5%, statins) was used by 52% of participants. LLA use 1-4 years was associated with lower odds of PPD ⩾ 4 mm (OR: 0.22, 0.005; high low tertile) or lower odds of CAL ⩾ 4 mm (OR: 0.33, 0.02, middle low tertile), compared to those with LLA minimal or no use. This association was lost for participants who used LLA for >4 years. LLA users for >4 years with periodontal disease had elevated HbA1c (OR: 1.36, 0.05).
The use of LLA for 1-4 years was associated with lower values of periodontal parameters minimal LLA use. This association was not present among people using LLA > 4 years users, but these participants had poorer glycemic control compared to other participants. In this cross-sectional study, the finding that LLA use 1- 4 years is associated with lower values of periodontal parameters of severity in T2D individuals may help clarify some of the controversies regarding the benefit of these medications in this population.
近期研究表明，降脂药物（LLA）可能会减轻慢性牙周炎，但这种益处是否也适用于2型糖尿病（T2D）患者尚不清楚。
我们评估了LLA的使用与西班牙裔T2D成年患者牙周炎之间的关联。
这是一项横断面观察性研究。
我们评估了参与“牙周炎与糖尿病研究中的降脂药物使用情况”研究的253名40 - 65岁患有T2D的波多黎各人中LLA的使用与牙周参数之间的关联。参与者被分为（a）未使用或使用时间<1年、（b）使用1 - 4年、或（c）使用时间>4年。主要结局指标是探诊深度（PPD）≥4mm的位点所占三分位数百分比，次要结局指标包括临床附着丧失（CAL）≥4mm的位点所占三分位数。使用经年龄、性别、吸烟状况、教育程度。腰围、糖化血红蛋白A1C（HbA1c）、探诊出血情况、检查者以及抗炎药物校正的多项逻辑回归模型来评估这种关联。
52%的参与者使用了LLA（92.5%为他汀类药物）。与极少使用或未使用LLA的参与者相比，使用LLA 1 - 4年与PPD≥4mm的较低几率（比值比：0.22，95%置信区间：0.005；高三分位数与低三分位数相比）或CAL≥4mm的较低几率（比值比：0.33，95%置信区间：0.02，中间三分位数与低三分位数相比）相关。对于使用LLA超过4年的参与者，这种关联消失。使用LLA超过4年且患有牙周疾病的参与者HbA1c升高（比值比：1.36，95%置信区间：0.05）。
使用LLA 1 - 4年与牙周参数值较低相关，而极少使用LLA则不然。在使用LLA超过4年的参与者中不存在这种关联，但与其他参与者相比，这些参与者的血糖控制较差。在这项横断面研究中，使用LLA 1 - 4年与T2D个体牙周炎严重程度的较低参数值相关这一发现，可能有助于澄清关于这些药物对该人群益处的一些争议。
