牙周护理与中年2型糖尿病患者较低的透析起始风险相关：一项基于全国卫生保健数据库的6年随访队列研究

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2025-01-06 DOI:10.1111/jcpe.14105

Taro Kusama, Yudai Tamada, Ken Osaka, Kenji Takeuch

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引用次数: 0

摘要

目的探讨2型糖尿病（T2D）患者牙周护理与开始透析风险的关系。方法本回顾性队列研究使用的数据来自日本医疗数据中心（JMDC）索赔数据库（2015年1月至2022年8月）。纳入年龄在40-74岁之间的T2D患者。就诊与牙周护理和开始透析分别作为暴露变量和结果变量。我们拟合Cox比例风险模型，包括潜在混杂因素，以估计风险比（hr）和95%置信区间（95% ci）。结果在99,273名参与者中（平均年龄= 54.4岁[SD = 7.8]，男性= 71.9%），开始透析的发生率为0.92 / 1000人年。在对所有协变量进行调整后，接受牙周护理（HR = 0.68 [95%CI = 0.51-0.91]≥1次/年，HR = 0.56 [95%CI = 0.41-0.77]≥1次/6个月）的患者开始透析的风险显著低于未接受牙周护理的患者。结论：t2dm患者的牙周病护理与透析起始风险降低32%-44%相关。这表明将牙周护理纳入糖尿病管理可能有助于预防糖尿病肾病的进展并改善患者的预后。

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Periodontal Care Is Associated With a Lower Risk of Dialysis Initiation in Middle‐Aged Patients With Type 2 Diabetes Mellitus: A 6‐Year Follow‐Up Cohort Study Based on a Nationwide Healthcare Database

ObjectiveTo investigate the association between dental attendance with periodontal care and the risk of dialysis initiation in patients with type 2 diabetes mellitus (T2D).MethodsThis retrospective cohort study used data from the Japan Medical Data Center (JMDC) claims database (January 2015 to August 2022). Patients with T2D, aged 40–74, were included. Dental attendance with periodontal care and initiation of dialysis were used as the exposure and outcome variables, respectively. We fitted the Cox proportional hazards model, including potential confounders, to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs).ResultsAmong 99,273 participants (mean age = 54.4 years [SD = 7.8], male = 71.9%), the incidence rate of dialysis initiation was 0.92 per 1000 person‐years. After adjusting for all covariates, those with periodontal care (HR = 0.68 [95%CI = 0.51–0.91] for ≥ 1 time/year and HR = 0.56 [95%CI = 0.41–0.77] for ≥ 1 time/6 months) had a significantly lower risk of dialysis initiation compared to those without dental attendance.ConclusionPeriodontal disease care in patients with T2D is associated with a reduced risk of dialysis initiation by 32%–44%. This suggests that integrating periodontal care into diabetes management may help prevent the progression of diabetic nephropathy and improve patient outcomes.

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.