糖尿病前期患者糖代谢异常与慢性牙周炎的相关性

doi:10.19723/j.issn.1671-167X.2020.01.011

Abstract

Abstract:

Objective: To investigate the associations of impaired glucose metabolism and insulin resis-tance with chronic periodontitis in pre-diabetes patients. Methods: A cross-sectional analysis was conducted and we included a total of 171 pre-diabetes patients aged 30-65 years, free of diabetes. Pre-diabetes was defined as impaired fasting glucose (IFG) [fasting glucose (FG): 6.1-7.0 mmol/L] and/or impaired glucose tolerance (IGT) [oral glucose tolerance test (OGTT): 7.8-11.0 mmol/L]. Chronic periodontitis was defined according to Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) definition and the patients were divided into mild, moderate, and severe chronic periodontitis groups [mild: at least two interproximal sites with clinical attachment loss (CAL) ≥3 mm and at least two interproxima sites with probing depth (PD) ≥4 mm or 1 site with PD≥5 mm; moderate: at least two interproximal sites with CAL ≥4 mm and at least two interproxima sites with at least two interproximal sites with PD ≥5 mm; severe: at least two interproximal sites with CAL ≥6 mm and at least one interproxima site with at least two interproximal sites with PD≥5 mm]. A periodontal examination indexes [plaque index (PLI), PD, CAL, and bleeding on probing (BOP)] and glucose metabolism indexes [FG, OGTT, hemoglobinA1c (HbA1c), fasting insulin and homeostasis model assessments of insulin resistance (HOMA-IR)] were measured. The association of glucose meta-bolism and chronic periodontitis was investigated by multivariable logistic regression analysis. Results: FG in the moderate and severe chronic periodontitis groups was significantly higher compared with mild chronic periodontitis group, HOMA-IR in the moderate and severe chronic periodontitis groups was signi-ficantly higher compared with mild chronic periodontitis group, OGTT in the severe chronic periodntitis group was significantly higher compared with mild chronic peridontitis group and moderate chronic pe-riodontitis groups, and there was no significant difference between moderate and mild chronic periodontitis groups. For the insulin and HbA1c, there was no significant difference among mild, moderate and severe chronic periodontitis groups. After multivariable adjustment of age, gender, smoking status, hypertension and body mass index, IFG (OR=1.39, 95%CI: 1.01-1.98) and HOMA-IR (OR=1.36, 95%CI: 1.04-1.76) were associated with moderate periodontitis; IFG (OR=1.64, 95%CI: 1.17-2.40), IGT (OR=1.65, 95%CI: 1.21-2.26), and HOMA-IR (OR=1.72, 95%CI: 1.23-2.41) were significantly associated with severe periodontitis. Conclusion: Our data provided evidences that impaired glucose metabolism were associated with chronic periodontitis among pre-diabetes patients.

Key words: Pre-diabetes, Chronic periodontitis, Impaired glucose metabolism, Insulin resistance

CLC Number:

R781.4

Yong ZHANG,Chang LIU,Bin CHEN,Fan CHEN,Jin-yu DUAN,Meng-jun ZHANG,Jian JIAO. Associations of impaired glucose metabolism with chronic peridontitis in pre-diabetes patients[J].Journal of Peking University(Health Sciences), 2020, 52(1): 71-76.

Figures/Tables 4

Table 1

Table 2

Characteristics of general condition, periodontal status and glucose metabolism of patients in each group"

Items	Mild chronic periodontitis (n=74)	Moderate chronic periodontitis (n=55)	Severe chronic periodontitis (n=42)
Age/years, $x ?$ ±s	49.54±6.76	51.92±6.61	51.72±6.80
Gender (Male/Female), n	32/42	23/32	24/18
Smoking	11 (15%)	8 (15%)	7 (17%)
Hypertension	42 (57%)	30 (55%)	24 (57%)
BMI, $x ?$ ±s	22.34±4.65	22.68±4.52	23.27±3.61
Number of lost tooth, $x ?$ ±s	0.63±1.35	1.82±1.28^*	2.50±1.20^*
PLI, $x ?$ ±s	0.63±0.54	0.91±0.61^*	1.38±0.65^*#
PD/mm, $x ?$ ±s	2.42±0.15	3.31±0.21^*	3.64±0.72^*#
CAL/mm, $x ?$ ±s	1.09±0.51	2.22±0.71^*	2.83±1.23^*#
BOP/%, $x ?$ ±s	11±14	20±17^*	44±26^*#
FG/(mmol/L), $x ?$ ±s	5.89±0.44	6.22±0.43^*	6.61±0.50^*#
OGTT/(mmol/L), $x ?$ ±s	8.13±0.65	8.32±0.91	8.95±0.67^*#
HbA1c/%, $x ?$ ±s	5.55±0.52	5.57±0.51	5.65±0.47
Fasting insulin/(mIU/L), $x ?$ ±s	10.47±7.51	10.41±5.43	10.37±7.50
HOMA-IR, $x ?$ ±s	2.47±0.87	2.59±1.37^*	2.74±1.72^*#

Table 2

Table 3

Table 4

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Glucose metabolism	Mild chronic periodontitis (n=74)	Moderate chronic periodontitis (n=55)	Severe chronic periodontitis (n=42)
IFG	13 (18%)	7 (13%)	2 (5%)
IGT	46 (62%)	26 (47%)	10 (24%)
IFG+IGT	15 (20%)	22 (40%)^*	30 (71%)^*#

Items	Mild chronic periodontitis (n=74)	Moderate-severe chronic periodontitis (n=97)
Items	Mild chronic periodontitis (n=74)	OR	95%CI	P value
Fasting glucose	1	1.53	1.13-2.10	0.003
OGGT	1	1.35	1.04-1.75	0.018
HbA1c	1	1.17	0.88-1.55	0.828
Fasting insulin	1	0.95	0.90-1.00	0.056
HOMA-IR	1	1.57	1.17-2.10	0.004

Associations of impaired glucose metabolism with chronic peridontitis in pre-diabetes patients

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