糖尿病合并牙周病与糖脂代谢的关系

The relationship between diabetes mellitus associated periodontal disease and the metabolism of glucolipid

目的探讨糖尿病合并牙周病与血糖、血脂代谢的关系。方法将54例患者分为3组(A组:无糖尿病的中、重度牙周病患者16例;B组:2型糖尿病且牙周健康患者18例;C组:2型糖尿病合并中、重度牙周病患者20例),并检测TC、TG、LDL-C、HDL-C、空腹血糖(FBG)、糖基化血红蛋白(HbA1c)、高敏C反应蛋白(hsCRP)等。采用牙周治疗需要指数(CPI)评价牙周状况。结果 (1)B、C组患者FBG、TG、TC、LDL-C、HbA1c均明显高于A组(P<0.05)。(2)C组患者牙周袋探诊深度(probingdepth,PD)、牙周附着丧失(attachment loss,AL)均明显高于A组(P<0.01),B组患者PD、AL均明显低于A、C组(P<0.05)。(3)B、C组患者HDL-C均明显低于A组(P<0.05),C组患者HDL-C明显低于B组(P<0.01)。(4)C组患者hsCRP明显高于A、B组(P<0.01),A、B组患者hsCRP比较差异无统计学意义(P>0.05)。(5)CPI与FBG、HbA1c、hsCRP、TC、TG、LDL-C呈正相关(P<0.05、P<0.01),与HDL-C呈负相关(P<0.05、P<0.01)。结论牙周病的严重程度与血糖、TC、TG、LDL-C、HDL-C水平均有关,糖尿病合并牙周病患者更易发生糖脂代谢紊乱。

Objective To investigate the relationship between diabetes mellitus associated periodontal disease and the metabolism of plasma glucose,plasma lipid.Methods 54 subjects in our hospital were divided into 3 groups（A group：16 cases of middle and heavy periodontal disease patients without diabetes mellitus;B group：18 cases of simple type 2 diabetes mellitus patients;C group：20 cases of type 2 diabetes mellitus patients associated middle and heavy periodontal disease）.The levels of TC,TG,LDL-C,HDL-C,fasting plasma glucose（FBG）,glycosylated hemoglobin（HbA1c）,high-sensitive reactive protein C（hs-CRP） were measured：Community periodental index（CPI） of treatment needs was used to evaluate the state of periodontal.Results（1）The FBG,TG,TC,LDL-C and HbA1c were significantly higher in B and C groups than those in A group（P0.05）.（2）Probing depth（PD） and attachment loss（AL） were significantly higher in C group than that in A group（P0.01）,PD and AL were significantly lower in B group than that in A and C groups（P0.05）.（3） The level of HDL-C was higher in B and C groups than that in A group（P0.05）.The level of HDL-C was significantly lower in C group than that in B group.（4） The level of hs-CRP was higher in C group than that in A and B groups（P0.01）.The level of hs-CRP had no significant difference in A and B groups（P0.05）.（5） CPI was positively correlated with FBG,HbA1C,hs-CRP,TC,TG,LDL-C（P0.01）.CPI was negatively correlated with HDL-C（P0.01）.Conclusion The degree of periodontal disease is significantly and positively correlated with FBG,TG,TC and LDL-C.Patients with diabetes mellitus and periodontal disease are more obtained the disorder metabolism of glucolipid.