牙周病对糖尿病的影响

Ricardo Faria Almeida , Alfonso López Alba , Héctor J. Rodríguez Casanovas , David Herrera González
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引用次数: 9

摘要

在过去的几年里,各种研究表明,糖尿病不仅是牙周病的一个危险因素,而且牙周病可能影响血糖控制,在糖尿病并发症方面具有众所周知的后果。本文的目的是回顾牙周病对糖尿病的影响、代谢控制及其并发症的现有证据,以及这些发现的意义。牙周病是一种感染,它在牙周组织中引发免疫炎症反应,造成相关组织破坏的主要比例。牙周病的患病率在世界各地都很高,最近在西班牙和葡萄牙的研究证实了这一点。这些疾病的重要性不仅基于局部影响,如牙齿脱落,而且基于它们的全身后果。其中,牙周病已被证明影响糖尿病及其血糖控制,由于(除其他因素外)相关的全身性炎症。不同的研究表明,牙周炎与糖基化血红蛋白水平升高有关,无论是否患有糖尿病。此外,有研究表明,牙周炎可能会增加糖尿病发病的风险,以及糖尿病患者糖尿病并发症的高风险。相反,牙周治疗可以改善2型糖尿病患者的血糖控制,并最终减少糖尿病并发症。这些发现的影响是多方面的,影响到牙医、其他卫生专业人员和病人等。
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Efectos de las enfermedades periodontales sobre la diabetes

In the last few years, various studies have shown that diabetes is not only a risk factor for periodontal diseases, but also that periodontal diseases may affect glycaemic control, with the well known consequences in terms of diabetes complications. The aim of the present paper was to review the existing evidence on the impact of periodontal diseases on diabetes, its metabolic control, and its complications, as well as the implications of these findings.

Periodontal diseases are infections, which trigger an immune inflammatory response in the periodontal tissues, responsible for a major proportion of the associated tissue destruction. The prevalence of periodontal diseases is high all over the world, which is confirmed in recent studies, both in Spain and Portugal. The importance of these diseases is based, not only on the local effects, such as tooth loss, but also on their systemic consequences. Among them, periodontal diseases have been shown to affect diabetes and its glycaemic control, due to (among other factors) the associated systemic inflammation.

Different studies have shown that periodontitis is associated with a higher level of glycosylated haemoglobin, both in subjects with and without diabetes. Moreover, it has been suggested that periodontitis may increase the risk of diabetes onset, as well as a higher risk of diabetic complications for diabetes patients. Conversely, periodontal therapy may improve glycaemic control in type 2 diabetic patients and, eventually, decrease diabetes complications.

The implications of these findings are numerous, affecting dentists, other health professionals and patients, among others.

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