A new strategy for quantitative analysis of a major clinical biochemical indicator called glycatedhemoglobin(Hb·A1c)was proposed.The technique was based on the simultaneous near-infrared(NIR)spectral determinatio...A new strategy for quantitative analysis of a major clinical biochemical indicator called glycatedhemoglobin(Hb·A1c)was proposed.The technique was based on the simultaneous near-infrared(NIR)spectral determination of hemoglobin(Hb)and absolute HbAlc content(Hb·HbA1c)inhuman hemolysate samples.Wavelength selections were accomplished using the improvedmoving window partial least square(MWPLS)method for stability.Each model was establishedusing an approach based on randomness,similarity,and stability to obtain objective,stable,andpractical models.The optimal wavebands obtained using MWPLS were 958 to 1036 nm for Hband 1492 to 1858 nm for Hb·HbA1c,which were within the NIR overtone region.The validationroot mean square error and validation correlation coeficients of prediction(V-SEP,V-Rp)were 3.4g L^(-1) and 0.967 for Hb,respectively,whereas the corresponding values for Hb.HbAic were 0.63 g L^(-1) and 0.913.The corresponding V-SEP and V-Rp were 0.40% and 0.829 for the relativepercentage of HbA1c.The experimental results confirm the feasibility for the quantification of HbAlc based on simultaneous NIR spectroscopic analyses of Hb and Hb·HbA1c.展开更多
Layer-by-layer {PDDA/Hb}(n) films were assembled by means of alternate adsorption of positively charged poly(diallyldimethyl ammonium) (PDDA) and negatively charged hemoglobin (Hb) at pH 9.2 from their aqueous solutio...Layer-by-layer {PDDA/Hb}(n) films were assembled by means of alternate adsorption of positively charged poly(diallyldimethyl ammonium) (PDDA) and negatively charged hemoglobin (Hb) at pH 9.2 from their aqueous solutions on pyrolytic graphite (PG) electrodes. Film growth during adsorption cycles was demonstrated by cyclic voltammetry and UV-Vis spectroscopy. Direct electrochemistry of Hb in {PDDA/Hb}(n) films on PG was studied.展开更多
Hemoglobin K-Woolwich (Hb KW) is a rare hemoglobin variant with very few cases reported. It is most prevalent in West African countries, particularly Nigeria, Ghana, and the Ivory Coast. Some reports suggest Hb KW may...Hemoglobin K-Woolwich (Hb KW) is a rare hemoglobin variant with very few cases reported. It is most prevalent in West African countries, particularly Nigeria, Ghana, and the Ivory Coast. Some reports suggest Hb KW may be a clinically benign trait, whereas others indicate it may behave similarly to a β+ thalassemia. The combination of hemoglobin S and hemoglobin KW (Hb S/KW) is a rare double heterozygous disorder with little known clinical characteristics. We report the hematologic and clinical data on three patients with Hb S/KW to help describe the characteristics of this patient population. The first two cases represent first cousins, ages 3 and 2 years. They are clinically asymptomatic. They have normal hemoglobin and mean corpuscle volume (MCV) levels without reticulocytosis. The third case is of a 14-year-old male who is non-anemic with no microcytosis. He has been clinically well except for abdominal pain upon dehydration. On hemoglobin electrophoresis, these patients have Hb S levels slightly higher than typically observed with sickle cell trait and a delay of hemoglobin F to adult levels. There exists a need for more reports to better delineate the clinical course and management of these patients.展开更多
目的:探讨营养包(Ying Yang Bao,YYB)服用时长和频率与6~24月龄婴幼儿血红蛋白(Hemoglobin,Hb)水平和贫血率之间的阈值效应关系。方法:研究数据来自于早期儿童营养包干预长期营养健康作用评估项目。采用t检验和卡方检验比较连续变量和...目的:探讨营养包(Ying Yang Bao,YYB)服用时长和频率与6~24月龄婴幼儿血红蛋白(Hemoglobin,Hb)水平和贫血率之间的阈值效应关系。方法:研究数据来自于早期儿童营养包干预长期营养健康作用评估项目。采用t检验和卡方检验比较连续变量和分类变量的组间差异。采用限制性立方样条回归检验YYB服用时长和频率与儿童血红蛋白(Hb)水平和贫血率之间的非线性趋势,探索可能存在的阈值效应关系。结果:YYB服用时长与Hb水平和贫血率的非线性趋势检验P值分别为0.665和0.211,服用频率与Hb水平和贫血率的非线性趋势检验P值分别为0.110和0.157。YYB服用时长达到8.68个月时,Hb水平变化的斜率β=0,贫血发生风险的OR=1;YYB服用频率达5.6袋/周时,Hb水平变化的斜率β=0,服用频率达4.6袋/周时,贫血发生风险的OR=1。结论:YYB服用时长和频率与6~24月龄婴幼儿Hb水平和贫血率之间存在线性关联;改善Hb水平和贫血率的最低有效时长约为8.6个月,最低有效频率约为5~6袋/周。展开更多
BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentu...BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.展开更多
Cation-exchange high-performance liquid chromatography(CE-HPLC) is a widely used laboratory test to detect variant hemoglobins as well as quantify hemoglobins F and A2 for the diagnosis of thalassemia syndromes. It...Cation-exchange high-performance liquid chromatography(CE-HPLC) is a widely used laboratory test to detect variant hemoglobins as well as quantify hemoglobins F and A2 for the diagnosis of thalassemia syndromes. It's versatility, speed, reproducibility and convenience have made CE-HPLC the method of choice to initially screen for hemoglobin disorders. Despite its popularity, several methodological aspects of the technology remain obscure to pathologists and this may have consequences in specific situations. This paper discusses the basic principles of the technique, the initial quality control steps and the interpretation of various controls and variables that are available on the instrument output. Subsequent sections are devoted to methodological considerations that arise during reporting of cases. For instance, common problems of misidentified peaks, totals crossing 100%, causes of total area being above or below acceptable limits and the importance of pre-integration region peaks are dealt with. Ultimately, CE-HPLC remains an investigation, the reporting of which combines in-depth knowledge of the biological basics with more than a working knowledge of the technological aspects of the technique.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for th...BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.展开更多
<strong>Background: </strong>Type-2 diabetic patients (uncontrolled levels of glucose blood) usually have periodontal diseases and alveolar bone loss. <strong>Objectives: </strong>The present s...<strong>Background: </strong>Type-2 diabetic patients (uncontrolled levels of glucose blood) usually have periodontal diseases and alveolar bone loss. <strong>Objectives: </strong>The present study was designed to clarify the impact of severity of periodontal bone loss and the levels of glycated hemoglobin (HbA1c) on the periodontal clinical parameters of the 2017 World Workshop among type 2 diabetic patients in Saudi Arabia (Saudi and non-Saudi). <strong>Material and Methods: </strong>This study was done on 298 type 2 diabetic patients, selected from the internship clinics, College of Dentistry, King Khalid University, Abha, Saudi Arabia. The selection of patients was dependent on the levels of glycated hemoglobin (HbA1c), and they were categorized into controlled (<7% HbA1c) and uncontrolled type 2 diabetics (>7% HbA1c). All patients were divided according to the severity of periodontal bone loss into three groups, group I: mild periodontal bone loss, group II: moderate periodontal bone loss, and group III: severe periodontal bone loss. Clinical evaluation of periodontal diseases was carried out by clinical parameters according to the 2017 World Workshop. All data were collected and analyzed. A p-value of <0.05 was considered significant, and of <0.001 was considered highly significant. <strong>Results:</strong> The severity of periodontal bone loss were determined in controlled type 2 diabetics (<7% HbA1c) and compared to uncontrolled type 2 diabetics (>7% HbA1c). An increased percentage of patients with severe periodontal bone loss was observed in uncontrolled type 2 diabetics (>7% HbA1c) (42.9%), as compared to controlled type 2 diabetics (<7% HbA1c) (30.5%) without statistically significant (p = 0.251). An increased mean of age, clinical attachment loss (CAL), and percentage of radiographic bone loss (% RBL) were detected in controlled type 2 diabetics (<7% HbA1c), as compared to uncontrolled type 2 diabetics (>7% HbA1c). In contrast, we found an increased mean of plaque control record (PCR), gingival bleeding index (GBI), and periodontal pocket depth (PPD) in uncontrolled type 2 diabetics (>7% HbA1c) more than in controlled type 2 diabetics (<7% HbA1c) without statistically significant (p > 0.05). Moreover, the mean of age, PCR, CAL, % RBL, and PPD were more in the patients with severe periodontal bone loss, as compared to the patients with mild and moderate periodontal bone. Highly statistically significant differences were recorded (p < 0.001). <strong>Conclusion:</strong> This study demonstrates the role of uncontrolled diabetes as a risk factor for the increase in the severity of periodontal bone loss. Thus, we suggest including the glycated hemoglobin (HbA1c) levels with periodontal parameters in the evaluation of periodontal bone loss among type 2 diabetics.展开更多
基金supported by National Natural Science Foundation of China(No.61078040)the Science and Technology,Project of Guangdong Province(No.2012B031800917).
文摘A new strategy for quantitative analysis of a major clinical biochemical indicator called glycatedhemoglobin(Hb·A1c)was proposed.The technique was based on the simultaneous near-infrared(NIR)spectral determination of hemoglobin(Hb)and absolute HbAlc content(Hb·HbA1c)inhuman hemolysate samples.Wavelength selections were accomplished using the improvedmoving window partial least square(MWPLS)method for stability.Each model was establishedusing an approach based on randomness,similarity,and stability to obtain objective,stable,andpractical models.The optimal wavebands obtained using MWPLS were 958 to 1036 nm for Hband 1492 to 1858 nm for Hb·HbA1c,which were within the NIR overtone region.The validationroot mean square error and validation correlation coeficients of prediction(V-SEP,V-Rp)were 3.4g L^(-1) and 0.967 for Hb,respectively,whereas the corresponding values for Hb.HbAic were 0.63 g L^(-1) and 0.913.The corresponding V-SEP and V-Rp were 0.40% and 0.829 for the relativepercentage of HbA1c.The experimental results confirm the feasibility for the quantification of HbAlc based on simultaneous NIR spectroscopic analyses of Hb and Hb·HbA1c.
基金This work was supported by the National Natural Science Foundation of China.
文摘Layer-by-layer {PDDA/Hb}(n) films were assembled by means of alternate adsorption of positively charged poly(diallyldimethyl ammonium) (PDDA) and negatively charged hemoglobin (Hb) at pH 9.2 from their aqueous solutions on pyrolytic graphite (PG) electrodes. Film growth during adsorption cycles was demonstrated by cyclic voltammetry and UV-Vis spectroscopy. Direct electrochemistry of Hb in {PDDA/Hb}(n) films on PG was studied.
文摘Hemoglobin K-Woolwich (Hb KW) is a rare hemoglobin variant with very few cases reported. It is most prevalent in West African countries, particularly Nigeria, Ghana, and the Ivory Coast. Some reports suggest Hb KW may be a clinically benign trait, whereas others indicate it may behave similarly to a β+ thalassemia. The combination of hemoglobin S and hemoglobin KW (Hb S/KW) is a rare double heterozygous disorder with little known clinical characteristics. We report the hematologic and clinical data on three patients with Hb S/KW to help describe the characteristics of this patient population. The first two cases represent first cousins, ages 3 and 2 years. They are clinically asymptomatic. They have normal hemoglobin and mean corpuscle volume (MCV) levels without reticulocytosis. The third case is of a 14-year-old male who is non-anemic with no microcytosis. He has been clinically well except for abdominal pain upon dehydration. On hemoglobin electrophoresis, these patients have Hb S levels slightly higher than typically observed with sickle cell trait and a delay of hemoglobin F to adult levels. There exists a need for more reports to better delineate the clinical course and management of these patients.
文摘目的:探讨营养包(Ying Yang Bao,YYB)服用时长和频率与6~24月龄婴幼儿血红蛋白(Hemoglobin,Hb)水平和贫血率之间的阈值效应关系。方法:研究数据来自于早期儿童营养包干预长期营养健康作用评估项目。采用t检验和卡方检验比较连续变量和分类变量的组间差异。采用限制性立方样条回归检验YYB服用时长和频率与儿童血红蛋白(Hb)水平和贫血率之间的非线性趋势,探索可能存在的阈值效应关系。结果:YYB服用时长与Hb水平和贫血率的非线性趋势检验P值分别为0.665和0.211,服用频率与Hb水平和贫血率的非线性趋势检验P值分别为0.110和0.157。YYB服用时长达到8.68个月时,Hb水平变化的斜率β=0,贫血发生风险的OR=1;YYB服用频率达5.6袋/周时,Hb水平变化的斜率β=0,服用频率达4.6袋/周时,贫血发生风险的OR=1。结论:YYB服用时长和频率与6~24月龄婴幼儿Hb水平和贫血率之间存在线性关联;改善Hb水平和贫血率的最低有效时长约为8.6个月,最低有效频率约为5~6袋/周。
文摘BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.
文摘Cation-exchange high-performance liquid chromatography(CE-HPLC) is a widely used laboratory test to detect variant hemoglobins as well as quantify hemoglobins F and A2 for the diagnosis of thalassemia syndromes. It's versatility, speed, reproducibility and convenience have made CE-HPLC the method of choice to initially screen for hemoglobin disorders. Despite its popularity, several methodological aspects of the technology remain obscure to pathologists and this may have consequences in specific situations. This paper discusses the basic principles of the technique, the initial quality control steps and the interpretation of various controls and variables that are available on the instrument output. Subsequent sections are devoted to methodological considerations that arise during reporting of cases. For instance, common problems of misidentified peaks, totals crossing 100%, causes of total area being above or below acceptable limits and the importance of pre-integration region peaks are dealt with. Ultimately, CE-HPLC remains an investigation, the reporting of which combines in-depth knowledge of the biological basics with more than a working knowledge of the technological aspects of the technique.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.
文摘<strong>Background: </strong>Type-2 diabetic patients (uncontrolled levels of glucose blood) usually have periodontal diseases and alveolar bone loss. <strong>Objectives: </strong>The present study was designed to clarify the impact of severity of periodontal bone loss and the levels of glycated hemoglobin (HbA1c) on the periodontal clinical parameters of the 2017 World Workshop among type 2 diabetic patients in Saudi Arabia (Saudi and non-Saudi). <strong>Material and Methods: </strong>This study was done on 298 type 2 diabetic patients, selected from the internship clinics, College of Dentistry, King Khalid University, Abha, Saudi Arabia. The selection of patients was dependent on the levels of glycated hemoglobin (HbA1c), and they were categorized into controlled (<7% HbA1c) and uncontrolled type 2 diabetics (>7% HbA1c). All patients were divided according to the severity of periodontal bone loss into three groups, group I: mild periodontal bone loss, group II: moderate periodontal bone loss, and group III: severe periodontal bone loss. Clinical evaluation of periodontal diseases was carried out by clinical parameters according to the 2017 World Workshop. All data were collected and analyzed. A p-value of <0.05 was considered significant, and of <0.001 was considered highly significant. <strong>Results:</strong> The severity of periodontal bone loss were determined in controlled type 2 diabetics (<7% HbA1c) and compared to uncontrolled type 2 diabetics (>7% HbA1c). An increased percentage of patients with severe periodontal bone loss was observed in uncontrolled type 2 diabetics (>7% HbA1c) (42.9%), as compared to controlled type 2 diabetics (<7% HbA1c) (30.5%) without statistically significant (p = 0.251). An increased mean of age, clinical attachment loss (CAL), and percentage of radiographic bone loss (% RBL) were detected in controlled type 2 diabetics (<7% HbA1c), as compared to uncontrolled type 2 diabetics (>7% HbA1c). In contrast, we found an increased mean of plaque control record (PCR), gingival bleeding index (GBI), and periodontal pocket depth (PPD) in uncontrolled type 2 diabetics (>7% HbA1c) more than in controlled type 2 diabetics (<7% HbA1c) without statistically significant (p > 0.05). Moreover, the mean of age, PCR, CAL, % RBL, and PPD were more in the patients with severe periodontal bone loss, as compared to the patients with mild and moderate periodontal bone. Highly statistically significant differences were recorded (p < 0.001). <strong>Conclusion:</strong> This study demonstrates the role of uncontrolled diabetes as a risk factor for the increase in the severity of periodontal bone loss. Thus, we suggest including the glycated hemoglobin (HbA1c) levels with periodontal parameters in the evaluation of periodontal bone loss among type 2 diabetics.
