Asthana Garima, Palwankar Pooja, Pandey Ruchi
Periodontology, Manav Rachna Dental College, School of Dental Sciences, Manav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, IND.
Cureus. 2024 Sep 6;16(9):e68779. doi: 10.7759/cureus.68779. eCollection 2024 Sep.
Background The relationship between obesity and type 2 diabetes mellitus (T2DM) is inevitable. The increase in the occurrence of obesity all around the globe has proportionally increased the occurrence of comorbidities. Periodontitis is a multifactorial inflammation of the periodontium attributed to dysbiosis in the subgingival microflora which may ultimately result in tooth loss. A triad between T2DM, periodontitis, and obesity is ascertained. Aim The present study focuses on investigating the association of obesity and T2DM with periodontal health. Methodology This cross-sectional study was conducted for a period of six months (September 2022 to February 2023) on 181 subjects, as per the sample size calculated by the statistician, who were previously diagnosed with T2DM and were either obese or overweight. The glycemic control was assessed on the basis of HbA1c values of the subjects. The subjects underwent bioelectrical impedance analysis along with an anthropometric examination. Full mouth examination including bleeding on probing, pocket probing depth, clinical attachment level (CAL), and oral hygiene index-simplified (OHI-S) was also checked to assess the status of periodontal health, and periodontitis was classified according to the new classification of 2017. Results The obtained data was statistically analyzed and p-value≤0.05 was considered statistically significant. The maximum prevalence of Stage III Grade C Periodontitis (34.73%) was observed in the diabetic obese group than in the diabetic overweight group. The overall anthropometric variable, abdominal circumference, waist-hip ratio, and basal metabolic index (BMI) were higher in the obese group as they displayed poor glycemic control. BMI and CAL also showed a positive correlation. Conclusion A significant association between obesity and T2DM with periodontitis was confirmed by this study. Hence, a syndemic approach needs to be formulated by the medical fraternity in collaboration with dental surgeons for the effective management of this triad.
肥胖与2型糖尿病（T2DM）之间的关系是不可避免的。全球肥胖发生率的增加相应地增加了合并症的发生率。牙周炎是一种牙周组织的多因素炎症，归因于龈下微生物群的生态失调，最终可能导致牙齿脱落。已确定T2DM、牙周炎和肥胖之间存在三联征关系。
本研究重点调查肥胖和T2DM与牙周健康的关联。
根据统计学家计算的样本量，对181名先前被诊断为T2DM且肥胖或超重的受试者进行了为期六个月（2022年9月至2023年2月）的横断面研究。根据受试者的糖化血红蛋白（HbA1c）值评估血糖控制情况。受试者接受了生物电阻抗分析以及人体测量检查。还进行了全口检查，包括探诊出血、牙周袋探诊深度、临床附着水平（CAL）和简化口腔卫生指数（OHI-S），以评估牙周健康状况，并根据2017年的新分类对牙周炎进行分类。
对获得的数据进行统计分析，p值≤0.05被认为具有统计学意义。糖尿病肥胖组中III期C级牙周炎的患病率最高（34.73%），高于糖尿病超重组。肥胖组的总体人体测量变量、腹围、腰臀比和基础代谢指数（BMI）较高，因为他们的血糖控制较差。BMI与CAL也呈正相关。
本研究证实肥胖和T2DM与牙周炎之间存在显著关联。因此，医学界需要与牙科医生合作制定一种综合防治方法，以有效管理这一三联征。
