Du Yudie, Xiao He, Luo Ruihan, Li Guangyi, Ren Yixing
Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Institute of Hepatobiliary Pancreatic Intestinal Diseases, North Sichuan Medical College, Nanchong, China.
Front Nutr. 2025 Jun 17;12:1606223. doi: 10.3389/fnut.2025.1606223. eCollection 2025.
The intricate relationship between periodontitis and diabetes mellitus (DM) has emerged as a focal point in contemporary medical research. This study aimed to explore the role of glycated hemoglobin (HbA1c) in this relationship, examine the mechanistic theories that may underlie this connection, and summarize effective interventions.
Articles were retrieved from PubMed/Medline and Web of Science. All studies focusing on this bidirectional relationship were included and evaluated.
Several mechanism theories have been proposed, including alterations in oral flora, suppression of anti-inflammatory and antidiabetic control mechanisms in periodontitis, gene silencing due to reduced DNA demethylation, and significantly lower quantitative levels of platelet-rich fibrin (PRF). Non-surgical periodontal therapy (NSPT) is an effective intervention, and based on this, systemic antibiotics and propolis can also be used. Antimicrobial photodynamic therapy (aPDT) is also an adjunct to periodontal therapy, with indocyanine green currently receiving increased attention.
HbA1c links periodontitis and DM bidirectionally, with elevated levels contributing to the worsening of periodontal disease and tooth loss. Studies have confirmed this association in both diabetic and non-diabetic individuals, although some findings remain conflicting. While HbA1c may predict diabetes risk and periodontal severity, further research is needed to clarify this relationship.
There is a bidirectional relationship between periodontitis and DM, with HbA1c playing an important role in this relationship. However, this study has certain limitations regarding selection bias and methodology, necessitating further mechanistic exploration and clinical validation in subsequent research.
牙周炎与糖尿病（DM）之间复杂的关系已成为当代医学研究的焦点。本研究旨在探讨糖化血红蛋白（HbA1c）在这种关系中的作用，研究可能构成这种联系的机制理论，并总结有效的干预措施。
从PubMed/Medline和Web of Science检索文章。纳入并评估所有关注这种双向关系的研究。
已提出几种机制理论，包括口腔菌群改变、牙周炎中抗炎和抗糖尿病控制机制的抑制、DNA去甲基化减少导致的基因沉默以及富含血小板纤维蛋白（PRF）的定量水平显著降低。非手术牙周治疗（NSPT）是一种有效的干预措施，基于此，还可使用全身抗生素和蜂胶。抗菌光动力疗法（aPDT）也是牙周治疗的辅助手段，目前吲哚菁绿受到越来越多的关注。
HbA1c在牙周炎和DM之间双向关联，其水平升高会导致牙周疾病恶化和牙齿脱落。研究已在糖尿病和非糖尿病个体中证实了这种关联，尽管一些研究结果仍存在矛盾。虽然HbA1c可能预测糖尿病风险和牙周严重程度，但仍需进一步研究来阐明这种关系。
牙周炎和DM之间存在双向关系，HbA1c在这种关系中起重要作用。然而，本研究在选择偏倚和方法学方面存在一定局限性，后续研究需要进一步进行机制探索和临床验证。
