title: Role of smoking and HbA1c level in periodontitis among insulin-dependent diabetic patients.
abstract: OBJECTIVE
  The aim was to analyse the role of smoking and HbA1c level in attachment loss (AL) and probing depths (PDs) among insulin-dependent diabetic patients. MATERIAL AND-METHODS: The study subjects were selected from a group of 149 insulin-dependent diabetic patients and included 64 patients (39 men and 25 women) aged 30 years or older. Data were obtained from patient records and by clinical examination. The outcome variables were the number of sites with AL and PDs of 5-9 mm. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated using Poisson regression models. RR was adjusted for the number of teeth, dental calculus and age.
  
  
  RESULTS
  RR for AL among the smokers was 4.15 (95% CI: 2.30-7.63) and that for PD among the smokers was 7.96 (95% CI: 4.91-13.19). HbA1c was not related to AL or PD. Among smokers with HbA1c > 8.5, RR for AL was 12.34 (95% CI: 4.14-39.35), but RR was not elevated for PD.
  
  
  CONCLUSIONS
  It can be concluded that the poor metabolic control together with smoking is extremely detrimental for AL.
authors.affiliation: Department of Periodontology, Institute of Dentistry, University of Oulu, Finland. Anna-Maija.Syrjala@oulu.fi
authors.forename: Anna-Maija H
authors.initials: AM
authors.lastname: Syrjälä
authors.forename: Pekka
authors.initials: P
authors.lastname: Ylöstalo
authors.forename: Mirka C
authors.initials: MC
authors.lastname: Niskanen
authors.forename: Matti L E
authors.initials: ML
authors.lastname: Knuuttila
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D017622:Periodontal Attachment Loss / Q000209:etiology*; D010518:Periodontitis / Q000097:blood / Q000150:complications* / Q000473:pathology; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D012907:Smoking / Q000009:adverse effects*
chemical_list: D006442:Glycated Hemoglobin