An Association of Periodontitis and Diabetes

치주질환과 당뇨병의 관련성

This study was conducted to evaluate the association between periodontal disease and diabetes mellitus. The final analysis population of this study was composed of 4,830 adults with diabetes mellitus or periodontal disease and aged 19 years or older, based on the third-edition data of the 4th Korea National Health and Nutrition Examination Survey (KNHANES) (in 2009). Diabetic status and potential confounders were used in questionnaire materials and physical examination materials, and the presence of periodontal disease was used in the materials for oral health examination by a dentist. For diabetic status, fasting plasma glucose (FPG) levels <100 mg/dl were subcategorized into normal group and FPG levels ${\geq}100mg/dl$ into impaired fasting glucose group; glycosylated hemoglobin (HbA1c) levels <7% into normal group and HbA1c ${\geq}7%$ into diabetes group, on the basis of the American Diabetes Association. According to the 2009 Korea Health Statistics, the case where the pocket depth is 3 mm or more was defined as periodontal disease. The association between the two diseases was evaluated through $x^2$-test and logistic regression analysis using R-commander 2.14. In impaired fasting glucose group, community periodontal index (CPI) groups 3 to 4 had higher risks for periodontal disease 1.23 times (95% confidence interval, 1.07~1.42) than those of CPI groups CPI 0~2, even after adjustment for several confounders. In addition, periodontal disease and diabetes mellitus showed statistically significant differences depending on age, sex, income level, educational background, smoking status, alcohol consumption, and snack intake. The analyses of the third-edition data of the 4th KNHANES showed that there was a statistically significant association between periodontal disease and diabetes mellitus as examined by means of CPI in this study.

2009년 제 4기 3차년도 국민견강영양조사 자료를 이용하여 우리나라 성인의 치주질환과 당뇨병의 관련성에 대해 평가하고자 하였다. 지역사회치주지수와 혈액검사를 통해 당뇨병을 진단받거나 공복혈당장애에 대한 검사와 당화혈색소 자료가 모두 있는 만 19세 이상의 성인 4,830명이 최종분석대상자가 되었다. 치주질환의 유병률은 성별에 따라서는 남자인 경우, 연령에 따라서는 나이가 많은 경우, 월평균가 수수입과 교육수준이 낮을수록, 흡연 경험이 있고 현재 흡연자일수록, 음주량이 많을수록 높게 나타났다. 당뇨병의 경우 남자인 경우, 나이가 많고, 현재 흡연자일수록, 교육수준과 소득수준이 낮고 음주량과 간식섭취가 많을수록 유병률이 높게 나타났다. 공복혈당수치에 따른 치주질환 유병률은 공복혈당 100 mg/dl 미만은 38.6%, 100 mg/dl 이상은 57.9%로 나타나 100 mg/dl 이상에서 치주질환이 많았다(p<0.0001). 공복혈당장애의 위험은 지역사회치주지수검사에서 CPI가 0~ 2인 그룹을 기준으로 하였을 때 CPI가 3~4인 그룹이 2.18배 높게 나타났다.