Kosho Madeline X F, Verhelst Alexander R E, Teeuw Wijnand J, van Bruchem Sebastiaan, Nazmi Kamran, Gerdes Victor E A, Loos Bruno G
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands.
Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands.
J Clin Med. 2024 Dec 10;13(24):7512. doi: 10.3390/jcm13247512.
: Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are major global health concerns, and they often go undetected. Periodontitis shares risk factors and is associated with both conditions. Assessing MetS risk factors among dental patients, especially those with periodontitis, may contribute to early detection and prompt treatment. However, current information about MetS prevalence rates in dental settings is limited. Therefore, our aim was to investigate the prevalence of MetS among patients with generalized periodontitis stage III/IV (GenPD), localized periodontitis stage III/IV (LocPD), and non-periodontitis controls. We also investigated the prevalence of undiagnosed T2DM in the same population. Moreover, we performed a pilot study to evaluate the possibility of measuring fructosamine levels in oral rinse samples, as an alternative to HbA1c, to screen for hyperglycemia. : Periodontitis patients and non-periodontitis controls were recruited from a dental school, all aged ≥ 40 years. MetS prevalence was determined according to four different MetS definitions. T2DM prevalence was based on elevated HbA1c levels (HbA1c ≥ 7.0%). Biochemical analysis from blood was carried out by finger stick sampling. A subset of participants was asked to provide an oral rinse sample for the measurement of fructosamine, which was correlated to HbA1c from blood. : A total of 105 patients with periodontitis (GenPD stage III/IV: n = 44, LocPD stage III/IV: n = 61) and 88 non-periodontitis controls, with a mean age of 54.4 years, were included. The prevalence of MetS, according to four different MetS definitions, was 68.2-81.8% in GenPD patients, 42.6-62.3% in LocPD patients, and 52.3-69.3% in controls. The prevalence of T2DM, as evidenced by elevated HbA1c, was 20.5% in GenPD patients, 18.3% in LocPD patients, and 10.2% in controls ( = 0.094). A substantial number of subjects were not aware that they were being suspected to have T2DM, i.e., 13.6% in GenPD patients, 8.2% in LocPD patients, and 8.0% in controls ( = 0.335). In a subset of participants (n = 48), we found no significant correlation between HbA1c and oral fructosamine (r= 0.24, = 0.103). : The overall results showed a relatively high prevalence of patients with MetS and/or elevated HbA1c among periodontitis patients and controls in the dental school. Of those with suspected T2DM, a substantial number were not aware of having T2DM. Oral health care professionals could therefore contribute to early detection for T2DM and/or create awareness in patients at risk for a disease related to MetS. To date, initial results on the use of oral fructosamine as an alternative for HbA1c cast doubt, and further research is needed.
代谢综合征(MetS)和2型糖尿病(T2DM)是全球主要的健康问题,且常常未被发现。牙周炎与它们有共同的危险因素,并且与这两种病症都有关联。评估牙科患者(尤其是患有牙周炎的患者)的代谢综合征危险因素,可能有助于早期发现和及时治疗。然而,目前关于牙科环境中代谢综合征患病率的信息有限。因此,我们的目的是调查广泛性牙周炎III/IV期(GenPD)、局限性牙周炎III/IV期(LocPD)患者以及非牙周炎对照者中代谢综合征的患病率。我们还调查了同一人群中未诊断出的2型糖尿病的患病率。此外,我们进行了一项试点研究,以评估测量口腔冲洗液样本中果糖胺水平作为糖化血红蛋白(HbA1c)的替代方法来筛查高血糖的可能性。
牙周炎患者和非牙周炎对照者从一所牙科学院招募,年龄均≥40岁。根据四种不同的代谢综合征定义确定代谢综合征的患病率。2型糖尿病的患病率基于升高的糖化血红蛋白水平(糖化血红蛋白≥7.0%)。通过指尖采血进行血液生化分析。一部分参与者被要求提供口腔冲洗液样本以测量果糖胺,其与血液中的糖化血红蛋白相关。
共纳入105例牙周炎患者(广泛性牙周炎III/IV期:n = 44,局限性牙周炎III/IV期:n = 61)和88例非牙周炎对照者,平均年龄为
54.4岁。根据四种不同的代谢综合征定义,广泛性牙周炎患者中代谢综合征的患病率为68.2 - 81.8%,局限性牙周炎患者中为42.6 - 62.3%,对照者中为52.3 - 69.3%。糖化血红蛋白升高表明2型糖尿病的患病率在广泛性牙周炎患者中为20.5%,局限性牙周炎患者中为18.3%,对照者中为10.2%(P = 0.094)。相当一部分受试者不知道自己被怀疑患有2型糖尿病,即广泛性牙周炎患者中为13.6%,局限性牙周炎患者中为8.2%,对照者中为8.0%(P = 0.335)。在一部分参与者(n = 48)中,我们发现糖化血红蛋白与口腔果糖胺之间无显著相关性(r = 0.24,P = 0.103)。
总体结果显示,牙科学院的牙周炎患者和对照者中,代谢综合征和/或糖化血红蛋白升高的患者患病率相对较高。在那些疑似2型糖尿病的患者中,相当一部分人不知道自己患有2型糖尿病。因此,口腔保健专业人员可以促进2型糖尿病的早期发现,并提高有代谢综合征相关疾病风险患者的认识。迄今为止,关于使用口腔果糖胺替代糖化血红蛋白的初步结果令人怀疑,还需要进一步研究。