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齿状状态和龋齿对糖尿病相关并发症的作用:一项基于医院的横断面研究。

The role of dentate status and dental caries on diabetes-related complications: a hospital-based cross-sectional study.

作者信息

Thearawiboon Sunithi, Rojanaworarit Chanapong

机构信息

Dental Department, Prachathipat Hospital, Pathum Thani, Thailand.

Department of Population Health, School of Health Sciences, Hofstra University, Hempstead, New York, USA.

出版信息

J Med Life. 2024 Dec;17(12):1072-1081. doi: 10.25122/jml-2024-0405.

Abstract

This study explored the role of dentate status and dental caries on diabetes-related complications among patients with type 2 diabetes mellitus (T2DM). A hospital-based cross-sectional design was applied to collect data on diabetic patients attending integrated services for non-communicable diseases and oral health at a public hospital in Thailand. Diabetic complication outcomes included diabetic eye and foot complications and chronic kidney disease (CKD). The main independent variable of dentate status and dental caries was classified into three categories: dentate and caries-free, dentate with caries, and edentulous. The relationships were evaluated through epidemiological models depicted by directed acyclic graphs (DAGs). Multivariable Poisson regression with robust standard errors was applied to estimate prevalence ratios (PR) according to DAGs. Among 438 patients with T2DM, 62.8% were women, and an average age was 63.6 years. Most patients were dentate with dental caries (70.1%), and 8.2% were edentulous. Prevalence of diabetic foot complications and CKD were 37.1% and 10.1%. Six patients had eye complications. Regarding CKD outcome, PR estimates from univariable and multivariable models were 0.94-1.12 for the dentate with caries group and 1.67-2.31 for the edentulous group, all with non-significant values. Regarding foot complication outcome, PR estimates were 1.10-1.12 for the dentate with caries group and 1.26-1.37 for the edentulous group, all with non-significant values. Though not statistically significant, the magnitude and direction of PR suggested a possible hypothesis that, among patients with T2DM, edentulism might be related to a higher prevalence of CKD and diabetic foot complications as compared to being dentate and caries-free.

摘要

本研究探讨了牙齿状况和龋齿在2型糖尿病(T2DM)患者糖尿病相关并发症中的作用。采用基于医院的横断面设计,收集泰国一家公立医院就诊的非传染性疾病和口腔健康综合服务的糖尿病患者的数据。糖尿病并发症结局包括糖尿病眼部和足部并发症以及慢性肾脏病(CKD)。牙齿状况和龋齿的主要自变量分为三类:有牙且无龋齿、有牙且有龋齿、无牙。通过有向无环图(DAGs)描述的流行病学模型评估这些关系。应用具有稳健标准误的多变量泊松回归,根据DAGs估计患病率比(PR)。在438例T2DM患者中,62.8%为女性,平均年龄为63.6岁。大多数患者有牙且有龋齿(70.1%),8.2%无牙。糖尿病足部并发症和CKD的患病率分别为37.1%和10.1%。6例患者有眼部并发症。关于CKD结局,单变量和多变量模型中,有牙且有龋齿组的PR估计值为0.94 - 1.12,无牙组为1.67 - 2.31,均无统计学意义。关于足部并发症结局,有牙且有龋齿组的PR估计值为1.10 - 1.12,无牙组为1.26 - 1.37,均无统计学意义。尽管无统计学意义,但PR的大小和方向提示了一个可能的假设,即在T2DM患者中,与有牙且无龋齿相比,无牙可能与CKD和糖尿病足部并发症的患病率较高有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a19/11771835/f03c1200d7ea/JMedLife-17-1072-g001.jpg

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