Sub-antimicrobial doxycycline for periodontitis reduces hemoglobin A1c in subjects with type 2 diabetes: a pilot study.
Sub-antimicrobial doxycycline for periodontitis reduces hemoglobin A1c in subjects with type 2 diabetes: a pilot study.
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DOI：
10.1016/j.phrs.2011.06.024
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发表时间：
2011-12
影响因子：
9.3
通讯作者：
Hey-Hadavi, Judith
中科院分区：
文献类型：
--
作者：
Engebretson, Steven P.;Hey-Hadavi, Judith
关键词：
体外和动物研究表明四环素类药物可能在抑制非酶蛋白糖化方面发挥作用。我们对 45 名长期患有 2 型糖尿病（平均病程 9 年）和未经治疗的慢性牙周炎的患者进行了一项为期 3 个月的随机安慰剂对照试点临床试验，试验采用传统龈下清创术（牙周治疗）联合三个月的亚抗菌剂量多西环素 (SDD) 方案、两周的抗菌剂量多西环素 (ADD) 方案或安慰剂。受试者服用稳定剂量的口服降血糖药物和/或胰岛素。通过测量血红蛋白 A1c (HbA1c)、血浆葡萄糖和临床牙周病指标来评估治疗反应。在一个月和三个月的随访中，所有组的牙周炎临床指标均有所下降（数据将在其他地方提供）。三个月时，SDD 组的平均 HbA1c 水平从 7.2% 单位 ± 2.2(±SD) 降低了 0.9% 单位，降至 6.3% 单位 ±1.1，提高了 12.5%。相比之下，ADD 组（7.5%±2.0 至 7.8%±2.1）或安慰剂组（8.5%±2.0 至 8.5%±2.6）的 HbA1c 没有显着变化。与 ADD 组相比，SDD 组相对于基线的平均 HbA1c 变化显着更大 (p=0.04)，但安慰剂组则不然 (p=0.22)。此外，与 ADD 组或安慰剂组相比，SDD 组中较大比例的受试者经历了改善（p<0.05）。组间或组内的平均血浆葡萄糖水平没有显着差异。这项初步研究的结果表明，对于服用常规处方降糖药的 2 型糖尿病患者，通过龈下清创术治疗牙周炎并每日使用亚抗菌剂量多西环素 3 个月可能会降低 HbA1c。
In vitro and animal studies suggest a possible role for the tetracycline class of drugs in the inhibition of non-enzymatic protein glycation. We conducted a 3-month, randomized placebo-controlled pilot clinical trial of conventional sub-gingival debridement, (periodontal therapy) combined with either a three month regimen of sub-antimicrobial-dose doxycycline (SDD), a two week regimen of antimicrobial-dose doxycycline (ADD), or placebo in 45 patients with long-standing type 2 diabetes (mean duration 9 years) and untreated chronic periodontitis. Subjects were taking stable doses of oral hypoglycemic medications and/or insulin. Treatment response was assessed by measuring hemoglobin A1c (HbA1c),plasma glucose, and clinical periodontal disease measures. At one-month and three-month follow-up, clinical measures of periodontitis were decreased in all groups(data to be presented elsewhere). At three months, mean HbA1c levels in the SDD group were reduced 0.9% unitsfrom 7.2% units ± 2.2(±SD), to 6.3% units ±1.1, which represents a 12.5% improvement. In contrast, there was no significant change in HbA1c in the ADD (7.5%± 2.0 to 7.8%± 2.1) or placebo (8.5%± 2.0 to 8.5%± 2.6) groups. Mean HbA1c change from baseline was significantly greater in the SDD group compared with the ADD group (p=0.04) but not placebo (p=0.22). Moreover, a larger proportion of subjects in the SDD group experienced improvement (p<0.05) compared to the ADD or placebo groups. Mean plasma glucose levels were not significantly different between or within the groups. The results of this pilot study suggest that the treatment of periodontitis with sub-gingival debridement and 3-months of daily sub-antimicrobial-dose doxycycline may decrease HbA1c in patients with type 2 diabetes taking normally prescribed hypoglycemic agents.
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