Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes
Por:
Gómez-Díaz R.A., Ramírez-Soriano E., Hajj, JT, Cruz, EB, Galicia, CJ, Villasis-Keever M.A., Aguilar-Salinas C.A., Wacher N.H.
Publicada:
1 nov 2012
Resumen:
Objective: To evaluate the association between carotid intima-media thickness, buccodental status, and glycemic control in patients with type 1 diabetes. Methods: Cross-sectional study with consecutive cases attended in an outpatient clinic (n=69). Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded. Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire. Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study. Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected. Results: The mean age was 11.7±3.0years, with diabetes 5.1±3.3years. Mean HbA1c was 8.5±1.7%. Primary teeth were present in 52.2% and bacterial plaque in 94.2%. Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%). Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile (>8.5%) had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile (<7.0%) (p<0.05). Conclusions: More buccodental conditions and carotid intima-media thickness increase appeared in the patients with HbA1c level>8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes. © 2012 John Wiley & Sons A/S.
Filiaciones:
Gómez-Díaz R.A.:
Unidad de Investigación Médica en Epidemiología Clínica, Mexico City, Mexico
Ramírez-Soriano E.:
Unidad de Investigación Médica en Epidemiología Clínica, Mexico City, Mexico
Villasis-Keever M.A.:
UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City,, Mexico
Aguilar-Salinas C.A.:
Departmento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
Wacher N.H.:
Unidad de Investigación Médica en Epidemiología Clínica, Mexico City, Mexico
Radiodiagnóstico de la UMAE Hospital de Especialidades, Mexico City, Mexico
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