慢性歯周炎は2型糖尿病患者における腎機能障害のリスクファクターである

Chronic Periodontitis is a Risk Factor of Renal Dysfunction in Patients with Type 2 Diabetes.

抄録

背景:

本研究は、2型糖尿病（T2DM）患者における慢性歯周炎と腎機能障害との関連を検討するものである。

BACKGROUND: This study explores the association between chronic periodontitis and renal dysfunction in type 2 diabetic mellitus (T2DM) patients.

方法:

慢性歯周炎を有するT2DM患者169名を対象に観察研究を実施した。腎機能正常者（111例）と腎機能障害者（58例）の2群に分け，質問票により口腔内健康行動関連変数を取得した．歯周病の状態を調べ，ポケットのプロービングデプス（PD），臨床的付着レベル（CAL），出血指数（BI）を測定した．

METHODS: An observational study was conducted in 169 T2DM patients with chronic periodontitis. Patients were divided into 2 groups according to presence of normal renal function (n=111) and renal dysfunction (n=58), and oral health behavior-related variables were obtained by questionnaire. Periodontal status was examined, and pocket probing depth (PD), clinical attachment level (CAL), and bleeding index (BI) were measured.

結果:

重症歯周炎群では，軽度歯周炎群（7.68±1.58％），中等度歯周炎群（7.35±1.45％）に比べ，HbA1c値が有意に高く（8.53±1.61％），P=0.001であった．腎機能正常者と比較して，腎機能障害者はPD値が高く，CAL値が高く，残存歯数が少なく，残存歯数≧20の患者が少なかった．PD≧4mmの部位の割合（52.8％ vs 41.67％）は，腎機能障害患者で有意に高かった．口腔保健知識評価の得点に2群間で差はなかった．性別，年齢，BMI，喫煙，高血圧，HbA1c で調整した結果，PD≧4mm の部位の割合は T2DM 患者における腎機能障害の独立したリスクファクターであった．

RESULTS: The severe periodontitis group had a significant higher HbA1c level (8.53 ± 1.61%) as compared with the mild and moderate periodontitis groups (7.68±1.58%) and (7.35±1.45%), P=0.001. Compared with patients with normal renal function, patients with renal dysfunction had a higher PD value, higher CAL value, fewer remaining teeth, and were less likely to have remaining teeth ≥20. The percentage of sites with PD ≥4 mm (52.8% vs. 41.67%) was significantly greater in patients with renal dysfunction. There was no difference in the scores of oral health knowledge assessment between the 2 groups. After adjustment by gender, age, BMI, smoking, hypertension, and HbA1c, the percentage of the sites with PD≥4 mm was an independent risk factor of renal dysfunction in T2DM patients.

結論:

T2DM患者において、歯周炎を有する者は腎機能低下を起こしやすい可能性がある。

CONCLUSION: In patients with T2DM, those with periodontitis may be more susceptible to decreased kidney function.