The influence of type 1 and type 2 diabetes on periodontal disease progression: prospective results from the Study of Health in Pomerania (SHIP).
The influence of type 1 and type 2 diabetes on periodontal disease progression: prospective results from the Study of Health in Pomerania (SHIP).
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DOI：
10.2337/dc11-2453
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发表时间：
2012-10
期刊：
影响因子：
16.2
通讯作者：
Kocher T
中科院分区：
文献类型：
--
作者：
Demmer RT;Holtfreter B;Desvarieux M;Jacobs DR Jr;Kerner W;Nauck M;Völzke H;Kocher T
探讨糖尿病病因（1型糖尿病[T1 DM] vs. T2 DM）和血糖控制在预测5年牙周状况变化中的相关性。波美拉尼亚健康研究（SHIP）是一项基于人口的德国男性和女性分层抽样研究。健康参与者和确定患有T2 DM的参与者来自SHIP队列，T1 DM参与者来自引起SHIP的集水区的糖尿病诊所。有齿参与者（n = 2，626; 53%女性; 20-81岁）被纳入。通过医生诊断和/或HbA 1c ≥6.5%（未控制的糖尿病>7.0%）确定糖尿病。对糖尿病状态不知情的检查者进行随机的半口牙周检查，评估基线和随访时的探测深度（PD）和附着丧失（AL）（4个部位/牙齿）。受试者分为以下六组：1）无糖尿病（n = 2，280），2）新发T2 DM（n = 79），3）控制T2 DM（n = 80），4）不受控制T2 DM（n = 72），5）控制T1 DM（n = 43）和6）不受控制T1 DM（n = 72）。在多变量回归分析中，对上述糖尿病类别的平均PD变化（ΔMPD）、平均AL变化（ΔMAL）或偶发牙齿缺失值进行回归分析。所有参与者的平均（SD）ΔMPD和ΔMAL值分别为-0.08 ± 0.5 mm和0.08 ± 1.03 mm，34%的人失去了一颗或多颗牙齿。与无糖尿病的受试者相比，未控制的T2 DM受试者的ΔMPD ± SE更大（P < 0.05），而未控制的T1 DM或未控制的T2 DM受试者的ΔMAL更大（P < 0.05）。未控制的T1 DM和T2 DM均与未来牙齿脱落的风险增加相关（P < 0.05）。糖尿病控制，而不是病因，与未来牙齿脱落和加速AL进展。
To explore associations between diabetes etiology (type 1 diabetes mellitus [T1DM] vs. T2DM) and glycemic control in the prediction of 5-year periodontal status change. The Study of Health in Pomerania (SHIP) is a population-based stratified sample of German men and women. Healthy participants and those determined to have T2DM arose from the SHIP cohort, and T1DM participants were recruited from diabetes clinics in the catchment area that gave rise to SHIP. Dentate participants (n = 2,626; 53% women; 20–81 years of age) were included. Diabetes was determined via physician diagnosis and/or HbA1c ≥6.5% (uncontrolled diabetes >7.0%). Examiners blinded to diabetes status performed random half-mouth periodontal examinations, assessing probing depth (PD) and attachment loss (AL) (four sites/tooth) at baseline and follow-up. Participants were categorized into six groups as follows: 1) diabetes free (n = 2,280), 2) incident T2DM (n = 79), 3) controlled T2DM (n = 80), 4) uncontrolled T2DM (n = 72), 5) controlled T1DM (n = 43), and 6) uncontrolled T1DM (n = 72). In multivariable regressions, mean PD change (ΔMPD), mean AL change (ΔMAL), or incident tooth-loss values were regressed across the aforementioned diabetes categories. Mean (SD) ΔMPD and ΔMAL values among all participants were −0.08 ± 0.5 mm and 0.08 ± 1.03 mm, respectively, and 34% lost one or more teeth. Relative to diabetes-free participants, those with uncontrolled T2DM experienced greater ΔMPD ± SE (P < 0.05), whereas participants with either uncontrolled T1DM or uncontrolled T2DM realized greater ΔMAL (P < 0.05). Uncontrolled T1DM and T2DM were both associated with an increased risk of future tooth loss (P < 0.05). Diabetes control, but not etiology, was associated with future tooth loss and accelerated AL progression.