Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus
Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus
复制标题
DOI：
10.1902/jop.1996.67.10s.1085
复制
发表时间：
1996-10-01
影响因子：
4.3
通讯作者：
Pettit, DJ
中科院分区：
文献类型：
--
作者：
Taylor, GW;Burt, BA;Pettit, DJ
本研究验证了非胰岛素依赖型糖尿病（NIDDM）患者严重牙周炎会增加血糖控制不良风险的假设。对吉拉河印第安人社区居民的纵向研究数据进行了分析，其中包括18至67岁的有齿受试者，包括：1）基线诊断为NIDDM的受试者（2小时口服葡萄糖耐量试验后血糖至少200 mg/dL）; 2）基线糖化血红蛋白（HbA（1））低于9%; 3）在2年随访期内保持牙齿状态。每隔2年进行一次医学和牙科检查，将重度牙周炎分为两种情况进行单独分析：1）基线牙周附着丧失至少一个索引牙6 mm或以上;和2）至少一颗牙齿的基线放射学骨损失为50%或更多，80名受试者至少接受了一次随访检查，其中9名受试者在基线后间隔2年接受了两次随访检查，获得了牙周附着丧失的临床数据。88例受试者至少接受了一次随访检查，其中17例接受了两次随访检查，可获得放射学骨丢失数据。血糖控制不佳指随访时HbA ≥ 9%。为了增加样本量，将基线至第二次检查和第二次至第三次检查的观察结果合并，为了控制观察结果的非独立性，使用广义估计方程（GEE）进行回归建模。基线时重度牙周炎与随访时血糖控制不良的风险增加相关。GEE模型中其他统计学显著协变量为：1）基线年龄; 2）基线血糖控制水平; 3）基线时NIDDM更严重; 4）NIDDM持续时间;和5）基线时吸烟，这些结果支持将重度牙周炎视为血糖控制不良的危险因素，并建议治疗NIDDM患者的医生应警惕重度牙周炎的体征管理NIDDM。
THIS STUDY TESTED THE HYPOTHESIS THAT SEVERE PERIODONTITIS in persons with noninsulin-dependent diabetes mellitus (NIDDM) increases the risk of poor glycemic control. Data from the longitudinal study of residents of the Gila River Indian Community were analyzed for dentate subjects aged 18 to 67, comprising all those: 1) diagnosed at baseline with NIDDM (at least 200 mg/dL plasma glucose after a 2-hour oral glucose tolerance test); 2) with baseline glycosylated hemoglobin (HbA(1)) less than 9%; and 3) who remained dentate during the 2-year follow-up period. Medical and dental examinations were conducted at 2-year intervals, Severe periodontitis was specified two ways for separate analyses: 1) as baseline periodontal attachment loss of 6 mm or more on at least one index tooth; and 2) baseline radiographic bone loss of 50% or more on at least one tooth, Clinical data for loss of periodontal attachment were available for 80 subjects who had at least one follow-up examination, 9 of whom had two follow-up examinations at 2-year intervals after baseline. Radiographic bone loss data were available for 88 subjects who had at least one follow-up examination, 17 of whom had two follow-up examinations. Poor glycemic control was specified as the presence of HbA, of 9% or more at follow-up. To increase the sample size, observations from baseline to second examination and from second to third examinations were combined, To control for non-independence of observations, generalized estimating equations (GEE) were used for regression modeling. Severe periodontitis at baseline was associated with increased risk of poor glycemic control at follow-up. Other statistically significant covariates in the GEE models were: 1) baseline age; 2) level of glycemic control at baseline; 3) having more severe NIDDM at baseline; 4) duration of NIDDM; and 5) smoking at baseline, These results support considering severe periodontitis as a risk factor for poor glycemic control and suggest that physicians treating patients with NIDDM should be alert to the signs of severe periodontitis in managing NIDDM.