目的:牙周炎与血糖控制之间的关联是复杂的,通常被描述为“双向”。尽管流行病学研究已经广泛检查了这种关系,关于牙周炎病例定义的分歧仍然存在。本研究旨在评估病例定义对牙周病与血糖状态之间关联的影响。
方法:该研究是对美国国家健康与营养调查(NHANES)数据的二次分析,2009-2014年周期。使用不同的牙周炎病例定义评估牙周炎与糖化血红蛋白(HbA1c)之间的关联:疾病控制与预防中心和美国牙周病学会(CDC/AAP)的定义,社区牙周指数(CPI),≥1个部位,临床附着损失≥3mm(CAL),探测深度≥4mm(PD),≥1个部位,CAL≥4mm,PD≥4mm,第五届欧洲研讨会定义,Machtei等人。\'已建立的牙周炎\',2017年世界研讨会分类,和自我报告的牙周炎。比较了牙周炎和HbA1c之间的关联。
结果:牙周炎的患病率估计存在很大差异,以及应用不同病例定义时牙周炎与HbA1c之间的关联强度。CDC/AAP和III/IV期牙周炎始终与HbA1c升高显着相关。对于第三/第四阶段,糖尿病前期和糖尿病HbA1c的校正比值比分别为1.19和1.76.
结论:考虑CAL和PD的综合牙周炎病例定义,如CDC/AAP和2017年分类,似乎更好地检测牙周病和HbA1c之间的关联。
The association between periodontitis and glycaemic control is complex, and often described as \'bidirectional\'. Although epidemiological studies have examined this relationship extensively, a disagreement on periodontitis
case definition still exists. This study aimed to assess the influence of
case definition on the association between periodontal disease and glycaemic status.
The study is a secondary analysis of data from the United States National Health and Nutrition Examination Survey (NHANES), 2009-2014 cycles. The association between periodontitis and glycated haemoglobin (HbA1c) was assessed using different periodontitis case definitions: the definition by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP), Community Periodontal Index (CPI), ≥1 site with ≥3 mm clinical attachment loss (CAL) and ≥4 mm probing depth (PD), ≥1 site with ≥4 mm CAL and ≥4 mm PD, the 5th European Workshop definitions, Machtei et al. \'established periodontitis\', the 2017 World Workshop classification, and self-reported periodontitis. The associations between periodontitis and HbA1c were compared across the
case definitions.
There was substantial variability in prevalence estimates of periodontitis, and in the strength of association between periodontitis and HbA1c when different
case definitions were applied. The CDC/AAP and stage III/IV periodontitis were consistently significantly associated with elevated HbA1c. For stage III/IV, the adjusted odds ratios of prediabetes and diabetes HbA1c were 1.19 and 1.76, respectively.
Comprehensive periodontitis
case definitions that account for CAL and PD, such as the CDC/AAP and the 2017 classification, seem to better detect the association between periodontal disease and HbA1c.