| 1. The clinical epidemiological investigation of periodontal status in patients with type 2 diabetes and the analysis of risk factorsObjective To study the correlation between periodontitis and diabetes, to understand the periodontal status and characteristics of patients with type 2 diabetes, and associated risk factors analysis.Methods 121 diabetes patients(including 88 males and 33 females, 56±11.1 years old) were collected as type 2 diabetes group and 123 patients without systemic disease(including 79 males and 44 females, 54±8.2 years old)as control group. The periodontal status of these patients were check and the questionnaire surveys were carried on. We collected the venous blood of these patients to test fasting blood glucose, blood lipids and glycosylated hemoglobin. Data were used to perform epidemiological investigation, risk factor analysis and correlation studies.Results1. The prevalence of periodontitis, smoking, hypertension, family history of type 2 diabetes, regular exercise were significant differences between the two groups.2.The inflammatory reaction and periodontal tissue damage were severer in diabetesgroup than control group, the differences were statistically significant.3. As the deterioration of glucose control situation, higher prevalence of periodontitis in diabetes patients was obvious.4. According to whether suffering from chronic periodontitis, T2 DM patients were divided into two groups, patients with T2 DM and periodontitis group of 108 people, and 13 T2 DM patients without periodontitis. The levels of TG, TC, LDL and Hb Alc were significantly higher in T2 DM patients with periodontal disease.(P<0.05).5. The results of partial correlation analysis showed that PD of T2 DM patients are closely related to Hb Alc and TG levels.6.The results of multiariable logistic regression analysis showed that chronic periodontitis was one of the risk factors of type 2 diabetes.Conclusion Periodontal disease and type 2 diabetes were closely related to blood glucose, blood lipid metabolism disorders. Type 2 diabetic patients with periodontal disease were more likely to merge the blood glucose and lipid metabolism disorders when periodontal index increased. At the same time, blood glucose and lipid metabolic disorder would aggravate the severity of periodontal disease, there were two-way relationships between them.2. The influence of periodontal treatment to type 2 diabetes patients with chronic periodontitisObjective To observe the influence of periodontal non-surgical treatment to the metabolism and adipokines level in type 2 diabetes patients with periodontitis.Methods The collection of type 2 diabetes patients with periodontitis were divided into the experimental group and the control group, non-surgical periodontal treatments were proceeded in experimental group, the control group only accepted oral health education. At each time we observed the periodontal inflammation status, blood lipid, fasting blood glucose, glycosylated hemoglobin, and the levels of leptin, visfatin and TNF-α in gingival crevicular fluid and serum in two groups before and after treatment.Results1. After non-surgical periodontal treatments, the periodontal measurement(SBI, PD and AL) values of 3, 6 and 12 months were significantly lower than control group.2. The lipid measurements of experimental group and control group at 3, 6 and 12 months showed no significant difference.3. After treatment, the Hb A1 c values in experimental group significantly reduced at 6 and 12 months.4. After treatment,the GCF TNF-α concentration at 3, 6 and 12 months showed significantly different between two groups.5. 3 months after treatment the serum leptin level in experimental group were significantly lower than the control group. In experimental group, the GCF leptin concentration at 3 and 6 months were significantly higher than the control group, but at 12 months the GCF and serum leptin concentration dropped to the baseline.6. The levels of serum and GCF visfatin in the experimental group decreased significantly at 3, 6 and 12 months compared to the control group.7. Pearson correlation analysis showed that average serum visfatin level and SBI, PD showed significantly positive correlation; The level of GCF visfatin and SBI, PD showed significantly positive correlation. The serum leptin level and periodontal diagnosis index SBI and PD is related, The GCF level of leptin and periodontal diagnosis index SBI and PD showed negative correlation. The GCF level of TNF-α with PD and AL showed significantly positive correlation. The serum and GCF level of visfatin and Hb A1 c levels were positively correlated.Conclusion1. Periodontal non-surgical treatment can effectively reduce inflammation in the type2 diabetes mellitus patients with periodontal disease.2. The periodontal non-surgical treatment can effectively reduce the Hb A1 c level in T2 DM patients with periodontitis, the effect of blood glucose control could last to 1 year. For patients with T2 DM and chronic periodontitis, periodontal treatment may be one of the effective means of reducing plasma glucose.3. The effect of periodontal non-surgical treatment to blood lipid metabolism in type 2 diabetes patients with periodontal disease was not significant, but the results still need further study.4. After periodontal non-surgical treatment, the level of GCF TNF-α reduced, while the level of serum TNF-α was almost not affected in type 2 diabetes patients with periodontitis.5. The periodontal non-surgical treatment can affect the leptin levels in patients with type 2 diabetes and periodontitis only for short-term.6. The periodontal non-surgical treatment significantly reduced the GCF and serum visfatin levels in type 2 diabetes patients with periodontitis, the effect of the treatment could sustain to 12 months. |
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