Abstract:

Objective To investigate the correlation between the number of teeth lost and the degree of carotid atherosclerosis in hospitalized type 2 diabetes mellitus patients. Methods One hundred and seventy hospitalized type 2 diabetes mellitus patients in the Department of Endocrinology, the Second Hospital of Shanxi Medical University were selected. According to the number of missing teeth, the patients were divided into 0 missing tooth group (n=65), 1-8 missing tooth group (n=88), and ≥9 missing tooth group (n=17). The correlation between the missing tooth numbers and the incidence, number, Crouse score and plaque stability was analyzed, including laboratory examination indicators. Results ①In this study, the prevalence of carotid plaque was 74.7%, and patients with tooth loss was 61.8%. 55.9% had hypertension, 60.6% had hyperlipidemia, and 58.8% had a family history of diabetes. In terms of oral hygiene, less than 20% of the patients correctly used tooth-brushing method, dental floss or gap brush, and only 4.1% of the patients could adhere to regular oral examination. ②The missing tooth number was positively correlated with the occurrence of plaque (OR=1.277, 95%CI:1.080-1.509, P=0.004), the number of plaques (r=0.338, P<0.001), and the Crouse score of plaque (b=0.205, P<0.001). ③There was no significant correlation between the missing tooth numbers and unstable plaque, but the larger the number of missing teeth was, the higher the proportion of unstable plaque was (P>0.05). ④The level of plasma fibrinogen in the group with more than 9 missing teeth was higher than the groups with no missing teeth and 1-8 missing teeth (P<0.05). The number of missing teeth was not found to be associated with CHO, TG, HDL, LDL and HbA1c (P>0.05). Conclusion ①In this study, the level of glycosylated hemoglobin, the proportion of hypertension and hyperlipidemia, the overall detection rate of carotid plaque was high. The rate of missing teeth was high, and the oral hygiene habits and oral health awareness were poor. ②With the increase of the number of missing teeth, the incidence of carotid plaque increased, and the number of carotid plaque and plaque Crouse score also increased, suggesting that the missing tooth number may be an important risk indicator of carotid atherosclerosis and its severity. ③With the increase of the number of missing teeth, the proportion of unstable plaque increased. ④With the increase of the number of missing teeth, the plasma fibrinogen level also increased, suggesting that fibrinogen may be a systemic inflammatory indicator for the potential relationship between the degree of periodontal inflammation and CAS in T2DM patients.

Key words: missing tooth number, carotid artery plaque, Crouse score, fibrinogen, type 2 diabetes mellitus