Periodontal Treatment and the Risks of Cardiovascular Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study
Periodontal Treatment and the Risks of Cardiovascular Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study
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DOI：
10.2169/internalmedicine.56.7322
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发表时间：
2017-01-01
影响因子：
1.2
通讯作者：
Huang, Chien-Ning
中科院分区：
文献类型：
--
作者：
Peng, Chiung-Huei;Yang, Yi-Sun;Huang, Chien-Ning
目的牙周病可能是心血管疾病的易感因素。糖尿病，特别是严重牙周炎患者，增加心血管疾病死亡的风险。然而，牙周治疗的结果在不同的治疗方式之间存在差异。我们的目的是调查是否牙周治疗可以影响2型糖尿病和牙周问题的患者CVD的发生。方法回顾性队列研究，根据台湾国民健康保险（NHI）发布的数据集。该数据集由1999年至2001年接受保险福利的随机抽样的新诊断糖尿病患者组成;排除了18岁以下或1999年之前已患有CVD的患者。NHI代码用于识别治疗，包括龈下刮除术和皮瓣手术。患者的人口统计学变量采用1：4的倾向评分进行匹配。对所有受试者进行随访，直至CVD发作或2011年12月31日。A考克斯比例风险回归分析进行评估牙周治疗对心肌梗死，心力衰竭和stroke.Results的比率3039和12,156糖尿病患者分为先进的牙周治疗组和非先进的牙周治疗组，分别。考克斯比例风险分析显示，尽管CVD的总体发病率没有显著改善（风险比，HR 0.95; 95% CI 0.90-1.01），但高级牙周治疗降低了心肌梗死（HR 0.92; 95% CI 0.85-0.99）和心力衰竭（HR 0.60; 95% CI 0.45-0.80）的发生率。结论牙周病治疗可降低心血管疾病的发生率，尤其是心肌梗死和心力衰竭的发生率。2型糖尿病患者的饮食习惯有哪些？
Objective Periodontal disease may predispose individuals to cardiovascular disease (CVD). Diabetes mellitus, especially in patients with severe periodontitis, increases the risk of CVD mortality. However, the outcomes of periodontal therapy vary among the different treatment modalities. We aim to investigate whether periodontal treatment could influence the occurrence of CVD in patients with type 2 diabetes and periodontal problems.Methods A retrospective cohort study was conducted based on a dataset released by Taiwan National Health Insurance (NHI). The dataset was composed of randomly sampled, newly diagnosed diabetic patients who received insurance benefits from 1999 to 2001; patients who were younger than 18 years of age or who already had CVD before 1999 were excluded. The NHI code was used to identify the treatments, including subgingival curettage and flap operations. The patients' demographic variables were matched using a 1:4 propensity score. All of the subjects were followed up until the onset of CVD, or December 31, 2011. A Cox proportional hazards regression analysis was performed to evaluate the effects of periodontal treatment on the rates of myocardial infarction, heart failure and stroke.Results Three thousand thirty-nine and 12,156 diabetic subjects were classified into the advanced periodontal treatment group and the non-advanced periodontal treatment group, respectively. The Cox proportional hazards analysis revealed that although the overall incidence of CVD was not significantly improved (Hazard ratio, HR 0.95; 95% CI 0.90-1.01), advanced periodontal treatment reduced the rates of myocardial infarction (HR 0.92; 95% CI 0.85-0.99) and heart failure (HR 0.60; 95% CI 0.45-0.80). There was no significance difference in the incidence of stroke (HR 0.95; 95% CI 0.85-1.06).Conclusion Advanced periodontal therapy lowers the rate of CVD, especially myocardial infarction and heart failure. Dental management has a beneficial effect on the health of patients with type 2 diabetes.