Diabetes Mellitus Periodontal Dis Children & Adolescents

儿童糖尿病牙周病

• 批准号: 6619529
• 负责人: IRA B LAMSTER
• 金额: $ 40.02万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-08-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6619529
• 关键词: African American; Hispanic Americans; adolescence (12-20); bacteria infection mechanism; caucasian American; child (0-11); clinical research; dental disorder chemotherapy; diabetic nephropathy; diabetic neuropathy; diabetic retinopathy; glycation; human subject; human therapy evaluation; immunotherapy; insulin dependent diabetes mellitus; longitudinal human study; medical complication; metronidazole; noninsulin dependent diabetes mellitus; oral bacteria; pathologic process; periodontitis; periodontium disorder; racial /ethnic difference; tetracyclines

DESCRIPTION (Provided by the applicant): Periodontal disease is now recognized as the sixth clinical complication of diabetes mellitus. This association was based on clinical studies examining the prevalence of periodontitis in adults with diabetes. While a limited number of studies have examined the prevalence of periodontal disease in children and adolescents, and determined that increased gingival inflammation was present m young patients with diabetes, these studies suffer from a number of identifiable problems, including small sample size, heterogenous populations and a failure to consider patient variables related to diabetes (i.e., duration of disease, level of metabolic control). Studies in our laboratory have utilized a murine model to study the etiology of accelerated periodontal disease associated with diabetes and have implicated the increased expression and activation of the receptor for advanced glycation endproducts (RAGE) as a key step in generation of an exaggerated inflammatory response as measured by production of inflammatory cytokines and matrix metalloproteinases. Consequently, taking advantage of an established relationship with Naomi Berrie Diabetes Center on the Columbia Presbyterian Medical Center campus, we propose to broadly examine periodontal disease in children and adolescents with diabetes. We will determine the oral disease burden in children and adolescents with type 1 and type 2 diabetes, and examine the development of gingival inflammation/periodontal disease in the natural history of diabetes mellitus and in relation to other microvascular complications of disease, examine the pathologic mechanisms that account for development of periodontal pathology in young patients with type 1 and type 2 disease, and determine if periodontal therapy can improve metabolic management in adolescents with poor control. Lastly, we plan to develop an intervention for non-dental medical professionals to promote identification of oral disease and referral for treatment in children and adolescents with diabetes mellitus. These studies will markedly enhance our understanding of the pathologic basis and clinical course of the most recently described complication of a debilitating chronic disease.

描述（由申请人提供）：牙周病现已得到认可 作为糖尿病的第六种临床并发症。这个协会是 基于检查成人牙周炎患病率的临床研究 患有糖尿病。虽然有限的研究调查了患病率 儿童和青少年牙周病的发病率，并确定 年轻糖尿病患者的牙龈炎症增加， 这些研究存在许多明显的问题，包括小问题 样本量、异质人群以及未能考虑患者 与糖尿病相关的变量（即疾病持续时间、代谢水平 控制）。我们实验室的研究利用小鼠模型来研究 与糖尿病相关的加速牙周病的病因学 表明晚期受体的表达和激活增加 糖化终产物（RAGE）是产生夸大糖化终产物的关键步骤 通过炎症细胞因子的产生来测量炎症反应 基质金属蛋白酶。因此，利用既定的 与哥伦比亚长老会内奥米贝里糖尿病中心的关系 医疗中心校园，我们建议广泛检查牙周病 患有糖尿病的儿童和青少年。我们将确定口腔疾病 患有 1 型和 2 型糖尿病的儿童和青少年的负担，并检查 牙龈炎症/牙周病在自然环境中的发展 糖尿病史以及与其他微血管相关的病史 疾病并发症，检查其病理机制 年轻1型和2型患者牙周病理学的发展 疾病，并确定牙周治疗是否可以改善代谢管理 控制能力较差的青少年。最后，我们计划制定一项干预措施 为非牙科医疗专业人员促进口腔疾病的识别 以及转诊患有糖尿病的儿童和青少年的治疗。 这些研究将显着增强我们对病理基础的理解 以及最近描述的并发症的临床过程 使人衰弱的慢性疾病。