Dhamija Ritika, Tewari Sanjay, Gill Paramjeet Singh, Monga Nitika, Mittal Shweta, Duhan Jigyasa
Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
J Endod. 2025 Feb;51(2):124-131. doi: 10.1016/j.joen.2024.11.008. Epub 2024 Nov 22.
This cross-sectional study, as a preliminary part of an ongoing project, aimed to investigate the effect of apical peridontitis (AP) on glycated hemoglobin (HbA1c) and systemic inflammatory markers in diabetic individuals.
A total of 280 individuals (140 with type 2 diabetes mellitus [T2DM] and 140 healthy) with and without AP were enrolled. Sixty-four age-, gender-, and body mass index-matched participants each in T2DM with AP group (DAP), T2DM without apical periodontitis (D), systemically healthy controls with apical periodontitis (CAP), and without apical periodontitis (C) groups were evaluated. Radiologic and clinical oral examination was performed for confirming the diagnosis of AP and periapical index scoring (PAI). Blood analyses were carried out for interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hsCRP), and HbA1c assessment.
Significantly higher levels of IL-1β, TNF-α, and hsCRP were observed in patients with AP in both diabetes and control groups (P < .05). In the diabetes group, AP contributed to significantly raised levels of HbA1c compared with T2DM group patients without AP. After controlling for possible confounders, partial corelation coefficients revealed positive corelation of presence of AP as well as size of the periapical lesion with HbA1c and serum levels of inflammatory markers in both diabetic and healthy individuals. Multivariate linear regression analysis revealed both presence of AP (P < .05) as well as the size of lesion (P < .001) were found to significantly predict the HbA1c levels as well as the levels of IL-1β, IL-6, TNF-α, and hsCRP in both diabetic and non-diabetic individuals.
These findings suggest that both presence of AP and size of periapical lesion was associated with glycemic control and systemic inflammatory burden in patients with T2DM.
本横断面研究作为一个正在进行的项目的初步部分，旨在调查根尖周炎（AP）对糖尿病患者糖化血红蛋白（HbA1c）和全身炎症标志物的影响。
共纳入280名个体（140名2型糖尿病患者[T2DM]和140名健康个体），他们有或没有AP。对2型糖尿病伴AP组（DAP）、2型糖尿病无根尖周炎组（D）、全身健康伴根尖周炎对照组（CAP）和无根尖周炎对照组（C）中各64名年龄、性别和体重指数匹配的参与者进行了评估。进行了放射学和临床口腔检查，以确诊AP并进行根尖指数评分（PAI）。进行血液分析以评估白细胞介素（IL）-1β、IL-6、肿瘤坏死因子（TNF）-α、高敏C反应蛋白（hsCRP）和HbA1c。
糖尿病组和对照组中患有AP的患者的IL-1β、TNF-α和hsCRP水平均显著更高（P < 0.05）。在糖尿病组中，与无AP的T2DM组患者相比，AP导致HbA1c水平显著升高。在控制了可能的混杂因素后，偏相关系数显示，在糖尿病和健康个体中，AP的存在以及根尖周病变的大小与HbA1c和炎症标志物血清水平呈正相关。多变量线性回归分析显示，AP的存在（P < 0.05）以及病变大小（P < 0.001）均能显著预测糖尿病和非糖尿病个体的HbA1c水平以及IL-1β、IL-6、TNF-α和hsCRP水平。
这些发现表明，AP的存在和根尖周病变的大小与2型糖尿病患者的血糖控制和全身炎症负担有关。
