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- 2017
龈沟血糖化血红蛋白筛查糖尿病的应用研究
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Abstract:
摘要 目的:评估在牙周探诊中获得的龈沟血(gingival crevicular blood,GCB)的糖化血红蛋白(HbAlc)是否可以代替手指末梢血(finger stick capillary blood,FSB)来筛查糖尿病(diabetes mellitus,DM)的可靠性,为DM筛查提供新渠道。方法:选取中重度慢性牙周炎患者,血糖仪检测GCB和FSB的血糖,Bio-rad D10全自动糖化血红蛋白分析仪检测GCB和FSB的HbAlc,Pearson相关系数分析GCB和FSB血糖以及HbAlc的相关性,受试者工作特征( receiver operating characteristic,ROC)曲线确定GCB HbAlc对DM的最佳诊断界值。结果:本研究收集了60例中重度慢性牙周炎患者,根据有无DM史、FSB血糖以及HbAlc的结果,发现18例有DM、42例无DM的牙周炎患者,两组GCB和FSB血糖的相关性分别为r=0.993和r=0.926;HbAlc的相关性分别为r=0.977和r=0.829;ROC曲线确定GCB HbAlc对DM的最佳诊断界值为HbAlc=5.7%,灵敏度为100%,特异度为95.2%。结论:与FSB HbA1c相比,牙周探诊获得的GCB进行HbA1c检测同样准确,最佳诊断界值为GCB HbAlc=5.7%,可能用于筛查DM患者
[1] | Glumer C, Yuyun M, Griffin S, et al. What determines the cost-effective-ness of diabetes screening [J]. Diabetologia, 2006, 49(7)∶1536-1544 |
[2] | Strauss SM, Alfano M, Shelley D, et al. Identifying unaddressed systemic health conditions at dental visits: patients who visited dentists but not general health care providers in 2008 [J]. Am J Public Health, 2012, 102(2)∶253-255 |
[3] | 李昆峰,吴娟,任阳,等.采用龈沟血筛查糖尿病的初步研究[J].口腔医学, 2014, (11)∶19-21 |
[4] | American Diabetes Association. Standards of Medical Care in Diabetes-2010 [J]. Diabetes Care, 2010,33(1)∶1-52 |
[5] | 胡建平,饶克勤,钱军程,等.中国慢性非传染性疾病经济负担研究[J].中国慢性病预防与控制,2007(3)∶189-193 |
[6] | Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases [J]. Lance, 2005, 366∶1809-1820 |
[7] | 刘文静,牛芳桥,胡轶,等.牙周炎对老年糖尿病患者口腔健康相关生活质量的影响[J].口腔医学研究,2016,32(6)∶627-630 |
[8] | Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases [J]. Nat Rev Endocrinol, 2011, 12(1)∶738-748 |
[9] | Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China [J]. N Engl J Med, 2010, 362(12)∶1090-1101 |
[10] | Fatemeh Sarlati, Elham Pakmehr, Kimia Khoshru, et al. Gingival Crevicular Blood for Assessment of Blood Glucose Levels [J]. J Periodontol Implant Dent, 2010, 2(1)∶17-24 |
[11] | Gaikwad S, Jadhav V, Gurav A, et al. Screening for diabetes mellitus using gingival crevicular blood with the help of a self-monitoring device [J]. J Periodontal Implant Sci, 2013, 43(1)∶37-40 |
[12] | Strauss SM, Wheeler AJ, Russell SL, et al. The potential use of gingival crevicular blood for measuring glucose to screen for diabetes: an examination based on characteristics of the blood collection site [J]. Journal of periodontology, 2009, 80(6)∶907-914 |
[13] | Rosedale MT, Strauss SM. Diabetes screening at the periodontal visit: patient and provider experiences with two screening approaches [J]. International journal of dental hygiene, 2012, 10(4)∶250-258 |
[14] | Strauss SM, Rosedale MT, Pesce MA, et al. The potential for glycemic control monitoring and screening for diabetes at dental visits using oral blood [J]. American journal of public health, 2015, 105(4)∶796-801 |