title: Association between periodontitis and impaired fasting glucose and diabetes.
abstract: OBJECTIVE
  Many studies have reported that periodontal disease is associated with diabetes, but its relation with impaired fasting glucose (IFG) has been understudied. This study investigated the relationship between chronic periodontitis, IFG, and diabetes in the U.S. population.
  
  
  METHODS
  Participants in the National Health and Nutrition Examination Survey III, aged ≥ 20 years, who received periodontal examinations and provided blood samples (n = 12,254) were grouped into quintiles of mean clinical attachment loss (CAL) and pocket depth, with the lowest category being the reference. Plasma fasting glucose was categorized into three groups (normal, <100 mg/dL; IFG, ≥ 100 but <126 mg/dL; and diabetic, ≥ 126 mg/dL). Sociodemographic factors and other potential risk factors were obtained by interview or examination. SAS 9.1 was used for statistical analysis accounting for the complex weighted sampling.
  
  
  RESULTS
  Participants in the top quintile category of CAL had higher prevalence odds of IFG (odds ratio [OR] 1.55 [95% CI 1.16-2.07]) and diabetes (4.77 [2.69-8.46]) after adjustment for related confounders, compared with those in the bottom quintile. The highest quintile of pocket depth was positively associated with IFG (1.39 [1.00-1.92]) and diabetes (1.63 [1.10-2.42]) compared with the lowest quintile. ORs for CAL increased from the lowest to the highest quintile (P value test for trend <0.01) for all outcomes. The ORs for pocket depth also tended to rise across quintiles.
  
  
  CONCLUSIONS
  Chronic periodontitis measured by CAL and pocket depth was positively associated in a linear relation with IFG and diabetes in U.S. adults.
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
authors.forename: Youn-Hee
authors.initials: YH
authors.lastname: Choi
authors.forename: Robert E
authors.initials: RE
authors.lastname: McKeown
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mayer-Davis
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.forename: Keun-Bae
authors.initials: KB
authors.lastname: Song
authors.forename: Anwar T
authors.initials: AT
authors.lastname: Merchant
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D055113:Chronic Periodontitis / Q000453:epidemiology* / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose