Age differences in the effects of multi-component periodontal treatments on oral and metabolic health among people with diabetes mellitus: A meta-epidemiological study.
Age differences in the effects of multi-component periodontal treatments on oral and metabolic health among people with diabetes mellitus: A meta-epidemiological study.
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多成分牙周治疗对糖尿病患者口腔和代谢健康影响的年龄差异：一项荟萃流行病学研究。
DOI：
10.1016/j.jdent.2023.104594
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发表时间：
2023
影响因子：
4.4
通讯作者：
Wu,Bei
中科院分区：
文献类型：
--
作者：
Zhu,Zheng;Qi,Xiang;Zheng,Yaguang;Pei,Yaolin;Wu,Bei
目的探讨牙周炎和糖尿病患者多组分牙周治疗对口腔和代谢指标影响的年龄差异。数据包括18岁及以上牙周炎和糖尿病患者多组分牙周治疗对口腔和代谢指标影响的试验。来源检索PubMed/Medline、Embase、CINHAL、Web of Science、科克伦图书馆和ProQuest等文献，检索时间从数据库建立到2022年8月。我们使用二元和多元荟萃回归模型来研究年龄和治疗效应量之间的关系。主要结果是探测深度（PD），临床附着水平（CAL）和血红蛋白A1 c（HbA 1c）的变化。其中，115项试验（119篇文章）符合纳入标准。参与者的平均年龄为58岁，从35岁到73岁不等。汇总证据表明，多组分牙周治疗显著降低了PD（g=0.929 [0.689-1.169]，I2=94.1%）、CAL（g=0.879 [0.669-1.089]，I2=92.1%）和HbA 1c（g=0.603 [0.443-0.763]，I2=87.5%）。随着年龄的增长，PD（趋势P = 0.020）和CAL（趋势P = 0.028）的效应量呈显著下降趋势。多变量荟萃回归的结果显示，平均年龄与PD（β=-0.123 [0.041]，P =0.004）和CAL（β=-0.159 [0.055]，P =0.006）的较小效应量相关。与年轻患者相比，55岁及以上患者的HbA 1c效应量较小（β=-0.792 [0.322]，P =0.017）。结论多组分牙周治疗在年轻人群中对PD、CAL和HbA 1c的影响可能更有效。临床医生在制定牙周治疗计划时应考虑到患者的年龄，并可能需要为老年人采用更积极或个性化的策略，以实现最佳效果。
ObjectiveTo explore the age differences in the effects of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes.DataTrials reporting the effects of multi-component periodontal treatments on oral and metabolic indicators among participants aged 18 and above with periodontitis and diabetes were included.SourcesSix databases (PubMed/Medline, Embase, CINHAL, Web of Science, Cochrane Library, and ProQuest) were searched from database inception to August 2022.Study selectionTwo reviewers selected the included studies independently. We used bivariate and multivariate meta-regression models to examine the association between age and treatment effect size. The primary outcomes were changes in probing depth (PD), clinical attachment level (CAL), and hemoglobin A1c (HbA1c).ResultsA total of 18,067 articles were identified in the database search. Of these, 115 trials (119 articles) met inclusion criteria. The mean age of participants was 58 years old, ranging from 35 to 73 years. The pooled evidence demonstrated that multi-component periodontal treatment significantly reduced PD (g=0.929 [0.689–1.169], I2=94.1%), CAL (g=0.879 [0.669–1.089], I2=92.1%), and HbA1c (g=0.603 [0.443–0.763], I2=87.5%). A significant decreasing trend was observed in the effect size for PD (Pfor trend = 0.020) and CAL (Pfor trend = 0.028) as age increases. Results from multivariate meta-regression showed that mean age was associated with a smaller effect size for PD (β=-0.123 [0.041],P =0.004) and CAL (β=-0.159 [0.055],P =0.006). Compared to their younger counterparts, the effect size for HbA1c was smaller among participants aged 55 and older (β=-0.792 [0.322],P =0.017).ConclusionsMulti-component periodontal treatments may be more effective in younger populations in terms of effects on PD, CAL, and HbA1c.Clinical significanceOur study highlights the importance of early intervention and tailored treatment approaches. Clinicians should take into account the patient's age when developing periodontal treatment plans and may need to employ more aggressive or personalized strategies for older adults to achieve optimal outcomes.