第二型糖尿病病人牙周健康狀況與血液中TNF-α、CRP的相關性

Abstract

Objective: The association between periodontal diseases (PDs) and diabetes mellitus (DM) was reported by many epidemiological and clinical studies and periodontal diseases have been considered as the sixth complication of diabetes. Inflammation plays an important role in both DM and PDs and tumor necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) are markers of systemic inflammation. Hence, we assessed periodontitis among patients with type 2 diabetes and further explored the relationship between the inflammatory markers (CRP and TNF-α) and periodontitis in this study. Materials and Methods: We designed a cross-sectional study of 139 type 2 diabetic patients and collected the data using a structured questionnaire and medical chart review. All diabetic patients received oral examinations including Community Periodontal Index (CPI) and plaque index (PLI). Blood samples were also collected. Results: 103 diabetic patients (74.1%) had periodontitis (CPI≧3). Diabetic patients with periodontitis had higher serum hsCRP and TNF-α levels but the differences were not statistically significant from DM patients without periodontitis. In the logistic regression analysis including potential risk factors, we found that smoking (OR=2.97，95% CI= 1.13~8.93，p=0.0361) and HbA1c＞7.5% (OR=2.45，95% CI= 1.04~6.08， p=0.0451) were associated with periodontitis in diabetic patients. Multiple linear regression analysis showed that BMI and HbA1c were positively associated with hsCRP level (p=0.0106，p=0.0045 respectively). Conclusion: The prevalence of periodontitis is high (74.1%) in type 2 diabetes. The level of sugar-control is related to the condition of oral health. The inflammatory markers (hsCRP and TNF-α) were higher (but not significantly) in diabetic patients with periodontitis as compared to those without periodontitis. However, we need a further study and more samples to determine the more vigorous relationship between oral health and TNF-α and hsCRP concentrations among diabetic patients.