Relationship between Periodontal Disease and Gestational Diabetes Mellitus

描述（由申请人提供）：妊娠期糖尿病（GDM）是指在妊娠期间发病或首次发现的血糖水平升高（或高甘油血症），占妊娠合并糖尿病的90%以上。在美国，GDM并发症约占所有妊娠的4%，每年影响约13.5万例。GDM与孕产妇和婴儿发病率的风险显著增加相关，包括巨大儿（出生体重4000克）、妊娠期高血压疾病（如先兆子痫）、剖宫产、早产、肩难产和出生损伤。患有GDM的女性在以后的生活中患2型糖尿病的风险明显更高。牙周病是人类最常见的感染性慢性疾病，可影响约20-50%的孕妇。牙周病导致菌血症、炎症和强烈的免疫反应，是某些全身性疾病（如心血管疾病、1型或2型糖尿病和不良妊娠结局）发展的重要危险因素。由于之前很少有研究探讨牙周病与GDM之间的可能关系，我们建议进行这项病例对照研究，以研究牙周病在GDM女性中是否比非GDM女性更普遍。我们将招募72名患有GDM的患者和72名未患有GDM的妇女进行产前检查。招募后，所有病例和对照组将由合格的牙医进行口腔检查。将评估牙周状况，并根据临床参数确定牙周病。将比较患有和不患有GDM的妇女患牙周病的比例。这项研究计划的长期目标是根据研究中确定的风险因素制定干预策略。我们的研究将有助于了解牙周病可能是GDM的危险因素。牙周病是可以预防和治愈的。如果我们的研究证实牙周病是GDM的危险因素，这将为预防GDM的干预研究打开大门。在怀孕前和怀孕期间改善口腔健康和治疗牙周病可以减少与GDM相关的孕产妇和围产期发病率，并预防妊娠后的2型糖尿病。

DESCRIPTION (provided by applicant): Gestational diabetes mellitus (GDM) is elevated blood glucose level (or hyperglycermia) with onset or first detection during pregnancy and represents more than 90% of all pregnancies complicated by diabetes. GDM complicates approximately 4% of all pregnancies in the U.S., affecting about 135,000 cases annually. GDM is associated with significantly increased risks of maternal and infant morbidity, including macrosomia (birth weight > 4000 g), hypertensive disorders in pregnancy (e.g., preeclampsia), cesarean section, preterm birth, shoulder dystocia and birth injury. Women with GDM are at a significantly higher risk of developing type 2 diabetes in their later life. Periodontal disease is the most common chronic disorder of infectious origin in humans and could affect about 20-50% of pregnant women. Periodontal disease results in bacteremia, inflammation, and a strong immune response, representing significant risk factors for the development of certain systemic diseases such as cardiovascular diseases, type 1 or 2 diabetes and adverse pregnancy outcomes. Because there are few previous studies that have examined the possible relationship between periodontal disease and GDM, we propose to conduct this case-control study to examine if periodontal disease is more prevalent in women with GDM than women without GDM. We will recruit 72 patients with GDM and 72 women without GDM during their antenatal care visits. After recruitment, an oral examination will be performed on all cases and controls by a qualified dentist. Periodontal status will be evaluated, and periodontal diseases will be defined by clinical parameters. The proportion of periodontal disease will be compared between women with and without GDM. The long-term goal of this research program is to develop intervention strategies that are based on the risk factors identified in the proposed study. Our study will contribute to an understanding of periodontal disease as a possible risk factor to GDM. Periodontal disease is preventable and curable. If periodontal disease is confirmed as a risk factor for GDM by our study, this will open the doors to intervention studies to prevent GDM. Improving oral health and treating periodontal disease before and during pregnancy may reduce maternal and perinatal morbidity associated with GDM and prevent type 2 diabetes after pregnancy.