探讨2型糖尿病与重度牙周炎的相关性及列线图模型的构建  

Nomogram model construction of periodontitis in diabetic patients

作　　者：温超 肖遵胜[1] 丁文萃[1] 葛超 刘璐 许可 曹素敏[1] 孙艳[1] WEN Chao;XIAO Zun-sheng;DING Wen-cui;GEChao;LIU Lu;XU Ke;CAO Su-min;SUN Yan(Department of Stomatology,Cangzhou Central Hospital,Cangzhou 061001,China)

机构地区：[1]沧州市中心医院口腔科,沧州061001

出　　处：《北京口腔医学》2024年第2期110-114,共5页Beijing Journal of Stomatology

基　　金：河北省医学科学研究课题计划项目(20211077)。

摘　　要：目的探讨2型糖尿病(T2DM)患者发生重度牙周炎的危险因素,并建立能够有效预测T2DM患者发生重症牙周炎风险的列线图模型。方法收集在我院进行治疗的217例T2DM患者的临床资料,根据是否发生重症牙周炎分为重度牙周炎组与非重度牙周炎组。通过单因素与多因素Logistics回归分析T2DM患者发生重度牙周炎的独立危险因素,根据危险因素建立相关风险列线图模型,并对模型的预测能力进行验证。结果吸烟、高脂血症、糖化血红蛋白(hs-CRP)、空腹血糖(FBG)以及超敏C反应蛋白(HbA1c)与T2DM患者重度牙周炎的发生密切相关,吸烟、伴有高脂血症以及高水平的HbA1c、FBG、hs-CRP均会显著增加T2DM患者重度牙周炎的发生风险。基于上述因素建立风险列线图模型,在对模型进行验证时发现校准曲线提示模型预测值与实际测量值一致,且模型拟合优度良好(Hosmer-Lemeshow检验得出P=0.627)。受试者工作特征(ROC)曲线显示AUC为0.892,提示所建立的模型对T2DM患者发生重度牙周炎具有良好的预测效能。结论吸烟、高脂血症、高水平HbA1c、高水平FBG以及高水平hs-CRP是T2DM患者发生重度牙周炎的独立危险因素,本研究建立的风险列线图模型能够有效预测T2DM患者发生重度牙周炎的概率,具有一定临床实用价值。Objective To investigate the risk factors of severe periodontitis in patients with type 2 diabetes mellitus(T2DM),and to establish a nomogram model that can effectively predict the risk of severe periodontitis in patients with T2DM.Methods The clinical data of 217 T2DM patients were collected.The patients were divided into severe periodontitis group and non severe periodontitis group.The independent risk factors of severe periodontitis in T2DM patients were analyzed by single factor and multivariate Logistics regression,and the related risk nomogram model was established according to the risk factors and the predictive ability of the model was verified.Results Smoking,hyperlipidemia,glycated hemoglobin(HbA1c),fasting blood glucose(FBG)and high sensitivity C-reactive protein(hs-CRP)were closely related to the occurrence of severe periodontitis in T2DM patients.Smoking,hyperlipidemia and high levels of HbA1c,FBG and hs-CRP significantly increased the risk of severe periodontitis in patients with T2DM.Based on the above factors,a risk nomogram model was established.The calibration curve indicated that the predicted value of the model was consistent with the actual measured value and the goodness of the model was good(Hosmer-Lemeshow test obtained P=0.627).The receiver operating characteristic(ROC)curve showed an AUC of 0.892,indicating that the established model has a good predictive power for the occurrence of severe periodontitis in T2DM patients.Conclusions Smoking,hyperlipidemia,high levels of HbA1c,high levels of FBG and high levels of hs-CRP are independent risk factors for severe periodontitis in T2DM patients.The risk nomogram model established in this study can effectively predict the probability of severe periodontitis in T2DM patients.

关 键 词：糖尿病 牙周炎 危险因素分析 列线图 

分 类 号：R781.42[医药卫生—口腔医学]