Association of periodontal parameters with metabolic level and systemic inflammatory markers in patients with type 2 diabetes.
BACKGROUND
Although worldwide evidence tends to prove that diabetes adversely affects periodontal health, there are insufficient clues indicating whether periodontitis may aggravate metabolic control and systemic inflammation. This study, as a preliminary part of an ongoing research project, aims to clarify the relationship of periodontal parameters with metabolic levels and systemic inflammatory markers in patients with diabetes.


METHODS
A total of 140 qualified, adult patients with type 2 diabetes and periodontitis were recruited into this study. Periodontal examinations, including a full-mouth assessment of probing depths (PDs), bleeding on probing, gingival recession, and clinical attachment level, were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting glucose, high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-alpha), and lipid profiles. Subjects were divided into three groups according to tertiles of the mean PD and compared.


RESULTS
Upon an analysis of covariance, subjects with an increased mean PD had significantly higher levels of HbA1c and hsCRP (P <0.05). No significant difference was found among different groups in the levels of serum TNF-alpha, fasting glucose, and lipid profiles (P >0.05). After controlling for age, gender, body mass index, duration of diabetes mellitus, smoking, regular physical exercise, and alcohol consumption, positive correlations were found between mean PD and HbA1c (r = 0.2272; P = 0.009) and between mean PD and hsCRP (r = 0.2336; P = 0.007). After adjustment for possible confounders, the mean PD emerged as a significant predictor variable for elevated levels of HbA1c and hsCRP (P <0.05).


CONCLUSIONS
Chronic periodontitis was associated with glycemic metabolic and serum hsCRP levels in patients with type 2 diabetes.
Chen
Lei
L
Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, Guangdong, China.
Wei
Bihong
B
Li
Jing
J
Liu
Fang
F
Xuan
Dongying
D
Xie
Baoyi
B
Zhang
Jincai
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000097:blood / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000150:complications; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha