title: Association between short leukocyte telomere length, endotoxemia, and severe periodontitis in people with diabetes: a cross-sectional survey.
abstract: OBJECTIVE Shortened leukocyte telomere length (LTL) and diagnosis of periodontitis are associated with an increased risk of complications and mortality in diabetes. This study investigated the association between LTL, endotoxemia, and severity of periodontitis in a large cohort of people with diabetes. RESEARCH DESIGN AND METHODS Six hundred thirty individuals (371 with type 2 and 259 with type 1 diabetes) were recruited from the University College Hospital in London, U.K. During a baseline visit, blood was collected for standard biochemical tests and DNA extraction, while a dental examination was performed to determine diagnosis and extent of periodontitis. LTL was measured by real-time PCR, and endotoxemia was assessed by the limulus amoebocyte lysate method. RESULTS Two hundred fifty-five individuals were diagnosed with gingivitis, 327 with periodontitis (114 with moderate and 213 with severe disease), and 48 with edentulous. Diagnosis of periodontitis was associated with shorter LTL (P = 0.04). A negative association between LTL and endotoxemia was found in the severe periodontitis and type 2 diabetes groups (P = 0.01 for both). Shorter LTL was associated with increased extent of periodontitis (P = 0.01) and increased insulin resistance (homeostatic model assessment). Multiple adjustments for biochemical, anthropometric, and medication-use variables did not affect the results. CONCLUSIONS LTL is associated with endotoxemia and diagnosis of periodontitis in people with diabetes. LTL shortening might represent a novel biological pathway accounting for previous epidemiological data that documented higher prevalence of diabetes and its complications in people with periodontitis and vice versa.
authors.affiliation: Corresponding author: Stefano Masi, s.masi@ucl.ac.uk.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masi
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gkranias
authors.forename: Kawa
authors.initials: K
authors.lastname: Li
authors.forename: Klelia D
authors.initials: KD
authors.lastname: Salpea
authors.forename: Mohamed
authors.initials: M
authors.lastname: Parkar
authors.forename: Marco
authors.initials: M
authors.lastname: Orlandi
authors.forename: Jean E
authors.initials: JE
authors.lastname: Suvan
authors.forename: Heng L
authors.initials: HL
authors.lastname: Eng
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
authors.forename: Kalpesh
authors.initials: K
authors.lastname: Patel
authors.forename: Ulpee
authors.initials: U
authors.lastname: Darbar
authors.forename: Nikos
authors.initials: N
authors.lastname: Donos
authors.forename: John E
authors.initials: JE
authors.lastname: Deanfield
authors.forename: Steve
authors.initials: S
authors.lastname: Hurel
authors.forename: Steve E
authors.initials: SE
authors.lastname: Humphries
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Aiuto
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D019446:Endotoxemia / Q000150:complications*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications*; D060888:Real-Time Polymerase Chain Reaction; D059506:Telomere Shortening