今回は
歯周病の重症度と2型糖尿病の発症の関連性を
調べています。
9296名に対し歯肉炎指数、歯周ポケットの有無
歯の動揺度、DMF指数により歯周病に罹患しているか
また重症度を評価し
一方、糖尿病の新規発症率を
死亡診断書・糖尿病薬物療法の自己申告
糖尿病による入院歴を基に割り出しています。
Type 2 diabetes and periodontal disease are known to be associated, but the temporality of this relationship has not been firmly established. We investigated whether baseline periodontal disease independently predicts incident diabetes over two decades of follow-up.
A total of 9,296 nondiabetic male and female National Health and Nutrition Examination Survey (NHANES I) participants aged 25–74 years who completed a baseline dental examination (1971–1976) and had at least one follow-up evaluation (1982–1992) were studied. We defined six categories of baseline periodontal disease using the periodontal index. Of 7,168 dentate participants, 47% had periodontal index = 0 (periodontally healthy); the remaining were classified into periodontal index quintiles. Incident diabetes was defined by 1) death certificate (ICD-9 code 250), 2) self-report of diabetes requiring pharmacological treatment, or 3) health care facility stay with diabetes discharge code. Multivariable logistic regression models assessed incident diabetes odds across increasing levels of periodontal index in comparison with periodontally healthy participants.
The adjusted odds ratios (ORs) for incident diabetes in periodontal index categories 1 and 2 were not elevated, whereas the ORs in periodontal index categories 3 through 5 were 2.26 (95% CI 1.56–3.27), 1.71 (1.0–2.69), and 1.50 (0.99–2.27), respectively. The OR in edentulous participants was 1.30 (1.00–1.70). Dentate participants with advanced tooth loss had an OR of 1.70 (P < 0.05) relative to those with minimal tooth loss.
Baseline periodontal disease is an independent predictor of incident diabetes in the nationally representative sample of NHANES I.
結果は歯周病コードの上位群で
糖尿病発症リスクが亢進。
ベースライン時の歯周病の存在は
2型糖尿病発症の予知因子という結論です。
歯周病菌から出される内毒素が血管内に入り込むことで
マクロファージのサイトカイン産生を促進し
これによりインスリンが作りにくくなる
ことが分かっていますが
このことを実証した文献でした。
．
引用文献
Ryan T. Demmer, David R. Jacobs, and Moïse Desvarieux
Periodontal Disease and Incident Type 2 Diabetes
Diabetes Care. 2008 Jul; 31(7): 1373–1379.