Salivary and microbiological parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus: a case-control study

Background: Several studies have investigated the differences in salivary parameters and microbial composition between diabetic and non-diabetic patients, however, specific differences are still not clear mainly due to the effects of confounder.Aim: The aim of this case-control study was to evaluate the salivary and microbial parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus.Material and method: This case-control study included 60 chronic periodontitis subjects, 30 diabetics (case group) and 30 non-diabetics (control group), paired according to periodontitis severity, gender and age. Stimulated whole saliva was collected from all volunteers to measure the salivary pH and the salivary flow rate. Bacterial samples were collected with paper points from periodontal sites showing the deepest periodontal pocket depth associated with the highest clinical attachment loss. The frequency of A. actinomycetemcomitans, P. intermedia, P. gingivalis, T. forsythiaand C. rectuswas evaluated by PCR. Data was statistically analyzed by Student's t, Mann-Whitney and Chi-square (p<0.05).Result: Diabetic subjects showed higher salivary glucose levels and lower stimulated flow rates in comparison to non-diabetic controls. P. gingivalisand T. forsythia were the most frequent pathogens (p<0.05). Bacterial frequency did not differ between case and control groups.Conclusion: Diabetes status influenced salivary glucose levels and flow rate. Within the same severity of chronic periodontitis, diabetic subjects did not show higher frequency of periodontal pathogens in comparison to their paired controls.

研究背景：已有多项研究探讨了糖尿病患者与非糖尿病患者的唾液参数及微生物组成差异，但受混杂因素影响，目前具体差异仍未明确。研究目的：本病例对照研究旨在评估伴与不伴2型糖尿病的慢性牙周炎患者的唾液与微生物参数。材料与方法：本研究共纳入60名慢性牙周炎受试者，按牙周炎严重程度、性别及年龄进行匹配，分为病例组（糖尿病患者）30例与对照组（非糖尿病患者）30例。采集所有受试者的刺激性全唾液，检测唾液pH值与唾液流率；使用纸尖采集牙周探诊深度最深且临床附着丧失最严重的牙周位点的细菌样本。采用聚合酶链式反应（PCR, Polymerase Chain Reaction）检测伴放线放线杆菌（A. actinomycetemcomitans）、中间普氏菌（P. intermedia）、牙龈卟啉单胞菌（P. gingivalis）、福赛斯坦纳菌（T. forsythia）及直形弯曲菌（C. rectus）的检出频率。采用t检验、曼-惠特尼U检验与卡方检验进行统计学分析，设定检验水准为p<0.05。研究结果：与非糖尿病对照组相比，糖尿病受试者的唾液葡萄糖水平更高，刺激性唾液流率更低。牙龈卟啉单胞菌与福赛斯坦纳菌为检出率最高的牙周致病菌（p<0.05）；两组间的细菌检出频率无显著差异。研究结论：糖尿病状态可影响唾液葡萄糖水平与唾液流率；在慢性牙周炎严重程度匹配的前提下，糖尿病患者的牙周致病菌检出频率并未高于配对对照组。