2型糖尿病和肥胖与牙周炎的关系

Relationship of type 2 diabetes and obesity with periodontitis

目的探讨肥胖和2型糖尿病(T2DM)与牙周炎的关系。方法选取200例行健康体检个体为研究对象。根据体质指数和腰臀比评估肥胖发生情况,并以血清空腹胰岛素和血糖水平评估T2DM发生情况。对所有研究对象进行全口牙周检查,探查菌斑指数、牙龈指数、探诊出血点、牙周袋深度和临床附着丧失情况。分析肥胖和T2DM患者牙周炎发生及牙周状况。采用Logistic回归模型分析肥胖、T2DM及肥胖合并T2DM与牙周炎发生的关系。结果肥胖患者的牙周炎发生率、菌斑指数、探诊出血点数、牙周袋深度以及临床附着丧失均高于或严重于非肥胖者(均P<0.05)。T2DM患者的牙周炎发生率、探诊出血点数、牙周袋深度以及临床附着丧失均高于或严重于非T2DM者(P<0.05)。肥胖者患牙周炎的风险是非肥胖非T2DM者的2.281倍(P<0.05),T2DM者患牙周炎的风险是非肥胖非T2DM者2.053倍(P<0.05),肥胖合并T2DM者患牙周炎的风险是非肥胖非T2DM者的4.182倍(P<0.05)。结论T2DM和肥胖在牙周炎的发生中或存在协同效应,牙周病的严重程度可能与肥胖、T2DM有关。

Objective To explore the relationship of type 2 diabetes mellitus(T2DM)and obesity with periodontitis.Methods Two hundred individuals undergoing physical examination were enrolled.The incidence of obesity was assessed according to their body mass index and waist-hip ratio,in addition,the incidence of T2DM was estimated on serum fasting insulin and blood glucose levels.Complete periodontal examination was performed on all subjects,including plaque index,gingival index,number of bleeding sites on probing,periodontal pocket depth,and clinical attachment loss.The incidence of periodontitis and periodontal conditions of obese patients with T2DM were analyzed.Logistic regression model was used to analyze the relationship of periodontitis with obesity,T2DM,and obesity complicated with T2DM.Results Obese patients exhibited higher incidence rate of periodontitis,higher plaque index,more bleeding sites on probing,higher periodontal pocket depth,and severer clinical attachment loss in comparison with patient with non-obesity(all P<0.05).Patient with T2DM exhibited higher incidence rate of periodontitis,more bleeding sites on probing,higher periodontal pocket depth,and severer clinical attachment loss as compared with patient without T2DM(P<0.05).Obese patients had 2.281 times risk for developing periodontitis than non-obesity patients without T2DM(P<0.05),T2DM patients had 2.053 times risk of suffering periodontitis than non-obesity patients without T2DM(P<0.05),and obese patients complicated with T2DM had 4.182 times risk for developing periodontitis than non-obesity patients without T2DM(P<0.05).Conclusion T2DM and obesity may exert synergistic effects in the occurrence of periodontitis.The severity of periodontal disease may be associated with obesity and T2DM.