Mirea Adina Andreea, Ștefan Adela Gabriela, Maria Moța, Clenciu Diana, Mitrea Adina, Efrem Ion Cristian, Roșu Maria Magdalena, Protasiewicz-Timofticiuc Diana Cristina, Vladu Beatrice Elena, Gheonea Theodora Claudia, Mărășescu Felicia, Eugen Moța, Vladu Ionela Mihaela
Department of Oro-Dental Prevention and Oral Health, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Calafat Municipal Hospital, 205200 Calafat, Romania.
Life (Basel). 2024 Dec 2;14(12):1585. doi: 10.3390/life14121585.
Diabetes mellitus is closely related to periodontal disease and dental lesions, disorders which through dental infection and metabolic imbalance become negatively potentiated and cause a vicious circle that is almost impossible to break. The aim of this research was to study if the severity of dental and periodontal lesions is related to the presence of microvascular complications and glycemic control in patients with type 2 diabetes mellitus (T2DM).
In total, 112 subjects with T2DM that underwent a dental evaluation were enrolled in this case-control study. The study group included 56 patients with complicated lesions, whereas the control group included 56 patients whose gender and age matched the study group and that presented superficial lesions. The statistical analysis was carried out using SPSS 26.0, with the result being considered statistically significant if the values were <0.05.
Statistically significant differences were recorded between the two groups regarding the value of blood glucose, HbA1c and fibrinogen, as well as kidney function. Statistically significant differences were also recorded between the two groups when analyzing the presence of microvascular complications, as well as individually analyzed, in the case of diabetic peripheral sensory-motor neuropathy ( < 0.001), but also of diabetic retinopathy ( < 0.05). This study developed a score with a predictive value for the presence of complicated dental and periodontal lesions, including blood glucose, fibrinogen, diabetic retinopathy, and diabetic peripheral neuropathy (AUROC 0.847, < 0.001).
There is a high frequency of dental and periodontal complications in patients with T2DM. Patients with microvascular complications, elevated fasting blood glucose, and chronic inflammation, as evidenced by elevated fibrinogen, are more likely to develop complicated dental and periodontal lesions.
糖尿病与牙周病和牙齿病变密切相关，这些疾病通过牙齿感染和代谢失衡而相互作用，形成恶性循环，几乎难以打破。本研究旨在探讨2型糖尿病（T2DM）患者牙齿和牙周病变的严重程度是否与微血管并发症的存在及血糖控制情况相关。
本病例对照研究共纳入112例接受牙科评估的T2DM患者。研究组包括56例有复杂病变的患者，而对照组包括56例性别和年龄与研究组匹配且有浅表病变的患者。使用SPSS 26.0进行统计分析，P值<0.05时结果被认为具有统计学意义。
两组在血糖值、糖化血红蛋白（HbA1c）、纤维蛋白原以及肾功能方面存在统计学显著差异。在分析微血管并发症的存在情况时，两组之间也存在统计学显著差异，单独分析时，糖尿病周围感觉运动神经病变（P<0.001）以及糖尿病视网膜病变（P<0.05）亦是如此。本研究制定了一个对复杂牙齿和牙周病变存在具有预测价值的评分，包括血糖、纤维蛋白原、糖尿病视网膜病变和糖尿病周围神经病变（曲线下面积0.847，P<0.001）。
T2DM患者牙齿和牙周并发症的发生率较高。有微血管并发症、空腹血糖升高以及纤维蛋白原升高所证明的慢性炎症的患者更有可能发生复杂的牙齿和牙周病变。
