Influences of leukocytes in patients with type 2 diabetes and periodontitis to the effects of periodontal treatment on glycemic control
10.3760/cma.j.cn112144-20210728-00347
- VernacularTitle:伴糖尿病牙周炎患者白细胞水平对牙周治疗后糖脂代谢指标的影响
- Author:
Pengcheng HUO
1
;
Jingling XU
;
Lu HE
;
Huanxin MENG
;
Bingtao YANG
;
Yunxuan ZHU
;
Dongsiqi JIN
Author Information
1. 北京大学口腔医学院·口腔医院牙周科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔生物材料和数字诊疗装备国家工程研究中心 口腔数字医学北京市重点实验室，北京 100081
- Keywords:
Periodontitis;
Diabetic mellitus, type 2;
Leukocytes;
Low-density lipoprotein;
Glycosylated hemoglobin
- From:
Chinese Journal of Stomatology
2022;57(7):716-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influences of leukocytes on improving blood glucose control in patients with type 2 diabetes mellitus (T2DM) and periodontitis after periodontal mechanical therapy.Methods:Thirty-five patients visiting Peking University Third Hospital from March 2011 to August 2012, as well as thirty-four patients visiting Peking University School and Hospital of Stomatology from March 2011 to August 2012 and December 2016 to December 2018 were selected in this research. These subjects were non-smokers, and with moderate to severe chronic periodontitis and T2DM. The full set of periodontal examinations including probing depth (PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were conducted. Besides, counts of white blood cells (WBC), parameters of glucose and lipids metabolites such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA 1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) in serum were examined before treatment. Then, oral hygiene instruction, scaling and root planing (SRP) were carried out. Three months after SRP, the baseline examinations were repeated in all patients. According to the baseline leukocyte counts, the patients were divided into subgroups: low WBC group (WBC<6.19×10 9/L) and high WBC group (WBC≥6.19×10 9/L). Paired t-test for comparison of changes after treatment, analysis of co-variance for comparing the intervention effects between subgroups, and multifactor Logistic regression analysis were performed. Results:Three months after SRP, all periodontal indexes were significantly improved in both groups. Leukocyte counts decreased significantly in high WBC group (6.89±1.53 vs. 7.64±1.51, P=0.008). In high WBC group, HbA 1c (7.18±1.09 vs. 7.67±1.35, P=0.001) and LDL (2.67±0.85 vs. 3.28±0.76, P=0.042) decreased significantly, while there were no such differences in low WBC group. Influence of leukocyte level on HbA 1c ( OR=0.12, P=0.038) and LDL ( OR=0.15, P=0.001) improvement was statistically significant. Hierarchical analysis showed such improvement notably perform in female [HbA 1c ( OR=0.30, P=0.021), LDL ( OR=0.34, P=0.001)] and severe periodontitis group [HbA 1c ( OR=0.15, P=0.025), LDL ( OR=0.24, P=0.017)]. Through interaction test, female and leukocyte counts at baseline had relative excess risk affecting the effect of periodontal intervention on HbA 1c ( P=0.036) and LDL ( P=0.005). Conclusions:SRP could significantly improve the blood glucose and lipid control in patients who had T2DM and chronic periodontitis with relative higher leukocytes level. Female patients with severe periodontitis showed more obviously effects.
