今回は歯周病ブログでお馴染みの糖尿病に罹患した場合の

口腔内の保菌数を真菌学的、細胞学的に検査し

局所的病因と全身的因子との関連を明らかに

することを目的とした文献です。

．

糖尿病患者55 名と非糖尿病対照被験者45 名に対して

口腔内検査や 頬粘膜を採取した真菌・細胞学的検査

唾液検査（pH，流出量測定）、 血糖測定を

行っています。

In this study, 55 diabetic patients and 45 non-diabetic control subjects were examined to determine oral candidal carriage state. The influence of some local aetiologic and systemic factors such as: salivary flow rate and pH, heredity, alcohol drinking, smoking habits, antimicrobial therapy, wearing of denture, burning sensation, dry mouth, taste alteration and tooth brushing habit on candidal carriage rate were investigated. Imprint culture, cytological smears and biochemical tests were used. Oral carrier rate and density of Candida species were non-significantly higher in the diabetic patients than in the non-diabetic control subjects. This increase was confirmed cytologically too. In both groups, Candida albicans was found to be a predominant species on tongue dorsum. Cigarette and alcohol habits of men were higher while tooth brushing habit was less than in women in diabetic and control groups. Salivary flow rate and pH values of diabetic patients were significantly lower while serum glucose values were significantly higher than of non-diabetic controls. The rate of diabetic patients suffering from dry mouth and having diabetic heredity in the family were significantly higher than control subjects. The candidal colonization was higher and keratinization was lower while diabetic treatment tended from diet and oral antidiabetic towards insulin. The decrease in salivary pH, the increase in serum glucose and wearing denture were correlated with the increased rate and density of C. albicans in both groups. Keratinization was also accompanied with the increase in leucocytes. In diabetic group, positive correlations were found between antimicrobial therapy and C. glabrata carriage; the increase in leucocytes and C. albicans carriage; the increase in keratinization and alcohol habit; serum glucose and smoking habit; dry mouth complaint and antimicrobial therapy. There was a negative correlation between salivary flow rate and C. albicans carriage. In control group a positive correlation was found between antimicrobial therapy and keratinization.

結果は

糖尿病患者群における唾液流量とpH は対照被験者群よりも有意に低かった。

糖尿病患者群において抗真菌療法とC. glabrata 保菌数

白血球数の増加とC.albicans

角化の増加とアルコール習慣

血糖値と喫煙習慣

口腔乾燥症状と抗真菌療法との間に正の相関が認められた。

一方、唾液流量とC. albicans との間には負の相関が認められた．

．

結論として

口腔内カンジダの発生率は対照被験者より

糖尿病患者において高度に認められ

カンジダ保菌数と各危険因子との間には

有意な相関が認められた

ということです。

引用文献

Kadir T, Pisiriciler R, Akyüz S, Yarat A, Emekli N, Ipbüker A

Mycological and cytological examination of oral candidal carriage in diabetic patients and non-diabetic control subjects: Thorough analysis of local aetiologic and systemic factors

J Oral Rehabil 2002 ; 29 : 452−457