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
AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing lo...AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.展开更多
BACKGROUND The bidirectional link between periodontitis and diabetes mellitus(DM)has been established.Periodontitis causes systemic inflammatory burden through inflammatory mediators.The currently utilized tools[clini...BACKGROUND The bidirectional link between periodontitis and diabetes mellitus(DM)has been established.Periodontitis causes systemic inflammatory burden through inflammatory mediators.The currently utilized tools[clinical attachment loss(CAL)and probing pocket depth(PPD)]are linear measurements,that do not exactly quantify the inflammatory burden of periodontitis.Periodontal inflamed surface area(PISA)quantifies the surface area of bleeding pocket epithelium and estimates the inflammatory burden.Studies relating to the periodontal status of diabetic patients with and without microvascular complications are scarce.This study assessed the proportion of periodontitis and correlation of PISA with glycemic status in controlled,uncontrolled type 2 DM(T2DM)with and without microvascular complications.AIM To assess the proportion of periodontitis and correlation of PISA with glycemic status in controlled,and uncontrolled T2DM with and without microvascular complications.METHODS This study comprised 180 T2DM patients.Based on glycated hemoglobin(HbA1c)levels,they were grouped into:(1)Controlled T2DMgroup:(HbA1c≤7%);(2)Uncontrolled T2DM group:(HbA1c>7%)without microvascular complications;and(3)Uncontrolled T2DM group:(HbA1c>7%)with microvascular complications.Each group comprised 60 patients.All patients were assessed for periodontal parameters(Bleeding on Probing,PPD,CAL,Oral hygiene index simplified and PISA),and systemic parameters(HbA1c,fasting plasma glucose and post prandial plasma glucose).RESULTS The proportion of periodontitis among controlled T2DM group,uncontrolled T2DM group without microvascular complications,uncontrolled T2DM group with micro-vascular complications was 75%,93.4%and 96.6%respectively.Extent and severity of periodontitis were high in the uncontrolled T2DM group.A significant positive correlation was found between PISA and HbA1c among all patients(r=0.393,P<0.001).The dose–response relationship between PISA and HbA1c was observed.An increase of PISA with 168 mm^(2) was associated with a 1.0%increase of HbA1c.CONCLUSION High proportion and severity of periodontitis,and increased inflamed surface area in uncontrolled T2DM may have contributed to the poor glycemic control and microvascular complications.展开更多
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AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.
文摘BACKGROUND The bidirectional link between periodontitis and diabetes mellitus(DM)has been established.Periodontitis causes systemic inflammatory burden through inflammatory mediators.The currently utilized tools[clinical attachment loss(CAL)and probing pocket depth(PPD)]are linear measurements,that do not exactly quantify the inflammatory burden of periodontitis.Periodontal inflamed surface area(PISA)quantifies the surface area of bleeding pocket epithelium and estimates the inflammatory burden.Studies relating to the periodontal status of diabetic patients with and without microvascular complications are scarce.This study assessed the proportion of periodontitis and correlation of PISA with glycemic status in controlled,uncontrolled type 2 DM(T2DM)with and without microvascular complications.AIM To assess the proportion of periodontitis and correlation of PISA with glycemic status in controlled,and uncontrolled T2DM with and without microvascular complications.METHODS This study comprised 180 T2DM patients.Based on glycated hemoglobin(HbA1c)levels,they were grouped into:(1)Controlled T2DMgroup:(HbA1c≤7%);(2)Uncontrolled T2DM group:(HbA1c>7%)without microvascular complications;and(3)Uncontrolled T2DM group:(HbA1c>7%)with microvascular complications.Each group comprised 60 patients.All patients were assessed for periodontal parameters(Bleeding on Probing,PPD,CAL,Oral hygiene index simplified and PISA),and systemic parameters(HbA1c,fasting plasma glucose and post prandial plasma glucose).RESULTS The proportion of periodontitis among controlled T2DM group,uncontrolled T2DM group without microvascular complications,uncontrolled T2DM group with micro-vascular complications was 75%,93.4%and 96.6%respectively.Extent and severity of periodontitis were high in the uncontrolled T2DM group.A significant positive correlation was found between PISA and HbA1c among all patients(r=0.393,P<0.001).The dose–response relationship between PISA and HbA1c was observed.An increase of PISA with 168 mm^(2) was associated with a 1.0%increase of HbA1c.CONCLUSION High proportion and severity of periodontitis,and increased inflamed surface area in uncontrolled T2DM may have contributed to the poor glycemic control and microvascular complications.
