Periodontal Infections and Type 2 Diabetes Mellitus Risk

2型糖尿病（糖尿病）是一个日益严重的公共卫生问题。慢性感染被认为是糖尿病的潜在危险因素，牙周感染和糖尿病之间也有已知的联系。虽然人们普遍认为牙周感染是现有糖尿病的结果，但越来越多的人支持牙周感染可能导致糖尿病发生的假设，尽管这方面的研究有限。支持牙周感染作为许多其他全身性疾病（即心血管疾病和妊娠结局）的危险因素的作用的证据不断增加，并进一步支持了目前的研究计划。此外，最近的报道暗示炎症是发生糖尿病的一个强大的危险因素。由于炎症反应是牙周病理的一个核心方面，因此探讨炎症是否可能介导牙周病和糖尿病之间的联系，或者仅仅是两种疾病过程的潜在因素，是很有兴趣的。目前的建议旨在验证牙周感染是糖尿病发展的一个病因因素的假设。将评估已知牙周病原体的基线暴露，以确定感染暴露的升高是否与空腹血糖和胰岛素水平的加速进展有关。这将通过在基线入组时年龄在25 - 55岁的男性和女性人群中n=300名参与者的纵向队列设计来实现。拟议的设计将仔细控制潜在的混杂因素，如空腹血糖、胰岛素、血脂、肥胖、饮食、年龄、吸烟、种族和性别的基线水平。

Type 2 diabetes mellitus (diabetes) is a growing public health problem. Chronic infections have been suggested as a potential risk factor for diabetes and there is a known association between periodontal infections and diabetes. Although it is generally believed that periodontal infections are a consequence of existing diabetes, there is growing support for the hypothesis that periodontal infections might contribute tq diabetogenesis, although research on this topic is limited. The evidence supporting the role of periodontal infections as a risk factor for a number of other systemic diseases (i.e., cardiovascular disease and pregnancy outcomes) continues to grow and further supports the rationale for. the current research proposal. Furthermore, recent reports implicate inflammation as a strong risk factor for incident diabetes. Since the inflammatory response is a central aspect of periodontal pathology, it is of interest to explore whether or not inflammation might mediate the association between periodontal disease and diabetes, or simply be an underlying contributor to both disease processes. The current proposal aims to test the hypothesis that periodontal infection is an etiologic factor in the development of diabetes. Baseline exposure to known periodontal pathogens will be assessed to see if elevated infectious exposure is associated with accelerated progression of fasting glucose and insulin levels. This will be achieved using a longitudinal cohort design among n=300 participants in a population of men and women aged 25 - 55 years at baseline enrollment. The proposed design will carefully control for potential confounders such as baseline levels of fasting glucose, insulin, lipids, obesity, diet, age, smoking, ethnicity and gender.