摘要
牙周炎与2型糖尿病之间存在明确的双向关系，但既往研究多聚焦于牙周状态与糖化血红蛋白之间的相关性，对糖尿病肾脏病等器官结局的关注相对不足。本文根据牙周状态分为中重度牙周炎组与非中重度牙周炎组。收集年龄、性别、体质指数、糖尿病病程、吸烟、高血压、降糖方案、糖化血红蛋白A1c（HbA1c）、尿白蛋白/肌酐比（UACR）和估算肾小球滤过率（eGFR）等资料，随访12个月。主要结局为血糖控制不达标（定义为随访终点HbA1c≥7.0%）；次要结局为早期糖尿病肾脏病进展（包括UACR分层升高、新发或持续微量白蛋白尿、eGFR下降达到预设阈值等）。采用多因素Logistic回归和Cox回归分析中重度牙周炎与结局之间的独立关联。
关键词： 2型糖尿病；牙周炎；血糖控制；糖尿病肾脏病；前瞻性队列研究
Abstract
There is a well-established bidirectional relationship between periodontitis and type 2 diabetes mellitus (T2DM). However, previous studies have mainly focused on the association between periodontal status and glycated hemoglobin, with relatively limited attention to organ outcomes such as diabetic kidney disease. In this study, participants were classified into a moderate-to-severe periodontitis group and a non-moderate-to-severe periodontitis group according to periodontal status. Data collected included age, sex, body mass index, duration of diabetes, smoking status, hypertension, glucose-lowering regimen, Glycated Hemoglobin A1c (HbA1c), urine albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR), and all participants were followed for 12 months. The primary outcome was poor glycemic control, defined as HbA1c ≥7.0% at the end of follow-up. The secondary outcome was progression of early diabetic kidney disease, including worsening of UACR category, new-onset or persistent microalbuminuria, and decline in eGFR beyond a prespecified threshold. Multivariable logistic regression and Cox regression analyses were performed to evaluate the independent associations of moderate-to-severe periodontitis with these outcomes.
Key words： Type 2 diabetes; Periodontitis; Glycemic control; Diabetic kidney disease; Prospective cohort study
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