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2 型糖尿病患者牙周组织对血糖控制的敏感性。

Periodontal tissue susceptibility to glycaemic control in type 2 diabetes.

机构信息

Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.

Japan Society for the Promotion of Science, Tokyo, Japan.

出版信息

Diabetes Obes Metab. 2024 Oct;26(10):4684-4693. doi: 10.1111/dom.15835. Epub 2024 Aug 14.

Abstract

AIM

To assess the direct effect of intensive glycaemic control on periodontal tissues in patients with diabetes mellitus.

MATERIALS AND METHODS

Twenty-nine patients with type 2 diabetes were enrolled and hospitalized to receive a 2-week intensive glycaemic control regimen. We observed and analysed the systemic and oral disease indicators before and after treatment and clarified the indicators related to periodontal inflammation.

RESULTS

A significant reduction in glycaemic and periodontal parameters, including glycated albumin levels and periodontal inflamed surface area (PISA), was observed after treatment. The changes in PISA per tooth, indicative of periodontal healing, exhibited a bimodal distribution; the patients were divided into two groups on this basis. Correlations were observed between the changes in PISA per tooth and fasting plasma glucose, acetoacetic acid, and beta-hydroxybutyrate levels in the PISA-improved group. Significantly lower levels of C-peptide, coefficient of variation of R-R interval, and ankle-brachial pressure index were observed before treatment in the PISA non-improved group.

CONCLUSIONS

Glycaemic control treatment can effectively improve periodontitis in patients with type 2 diabetes, even in the absence of specific periodontal treatments. However, the periodontal responsiveness to glycaemic control treatment depends on the systemic condition of the patient.

摘要

目的

评估强化血糖控制对糖尿病患者牙周组织的直接影响。

材料与方法

纳入 29 例 2 型糖尿病患者,住院接受为期 2 周的强化血糖控制治疗。观察并分析治疗前后的全身和口腔疾病指标,并明确与牙周炎症相关的指标。

结果

治疗后,糖化白蛋白水平和牙周炎炎症表面面积(PISA)等血糖和牙周参数显著降低。每颗牙的 PISA 变化呈双峰分布,基于此将患者分为两组。在 PISA 改善组中,每颗牙的 PISA 变化与空腹血糖、乙酰乙酸和β-羟丁酸水平之间存在相关性。在 PISA 未改善组中,治疗前 C 肽、R-R 间期变异系数和踝肱血压指数明显较低。

结论

血糖控制治疗可有效改善 2 型糖尿病患者的牙周炎,即使没有特定的牙周治疗。然而,血糖控制治疗对牙周的反应性取决于患者的全身状况。

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