Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease
Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease
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DOI：
10.1016/j.diabres.2008.10.016
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发表时间：
2009-03-01
影响因子：
5.1
通讯作者：
Izumi, Y.
中科院分区：
文献类型：
--
作者：
Katagiri, S.;Nitta, H.;Izumi, Y.
本研究旨在探讨牙周治疗结合局部抗生素治疗是否会影响2型糖尿病合并牙周病患者的糖蛋白（HbA1c）和血清高敏c反应蛋白（hs-CRP）水平，并探讨CRP与血糖控制的关系。整个干预组（n = 32）接受抗感染牙周治疗后，HbA1c水平仅短暂降低，hs-CRP无变化，而对照组（n = 17） HbA1c和hs-CRP均无变化。所有受试者的多元回归分析显示，在牙周治疗后6个月，BMI和hs-CRP的变化与HbA1c的降低有显著相关性。根据多元回归分析结果，将干预组再分为hs-CRP水平降低组（CRP-D组）和hs-CRP水平不变或升高组（CRP-N组）两组（n = 16），并根据这两组再进行分析。在CRP-D亚组中，HbA1c在研究结束时显著降低，但在CRP-N亚组中没有降低。牙周治疗后CRP-D亚组HbA1c的下降幅度明显大于CRP-N亚组，研究结束时各组BMI保持不变。因此，研究结果表明，局部抗生素牙周治疗可通过降低CRP改善2型糖尿病牙周病患者的HbA1c，这可能与改善胰岛素抵抗有关。2008爱思唯尔爱尔兰有限公司版权所有。
The purpose of this study was to examine whether periodontal treatment incorporating topical antibiotic therapy affects on levels of glycohemoglobin (HbA1c) and serum high-sensitivity C-reactive protein (hs-CRP) in type 2 diabetic patients with periodontal disease, and to explore the relationship between CRP and glycemic control. The whole intervention group (n = 32), which underwent anti-infectious periodontal treatment, showed only transient reduction in HbA1c levels without any change in hs-CRP, while the control group (n = 17) did not show any changes in HbA1c or hs-CRP. Multiple regression analysis of all subjects revealed that BMI and change in hs-CRP correlated significantly with the reduction of HbA1c at 6 months after the periodontal treatment. Based on the results of multiple regression analysis, the intervention group was subdivided into two groups: those in which hs-CRP levels decreased (CRP-D group), and those in which hs-CRP levels unchanged or increased (CRP-N group) (n = 16, respectively), and re-analysis was conducted based upon these subgroups. in the CRP-D subgroup, HbA1c was significantly reduced at the end of the study, but it did not decrease in the CRP-N subgroup. The decrease of HbA1c in the CRP-D subgroup following periodontal treatment was significantly greater than that in the CRP-N subgroup, BMI of each group remained unchanged in this study at the end of the study. Thus, the results suggested that periodontal treatment with topical antibiotics improves HbA1c through reduction of CRP, which may relate to amelioration of insulin resistance, in type 2 diabetic patients with periodontal disease. (C) 2008 Elsevier Ireland Ltd. All rights reserved.