title: Comparison of Frequency and Duration of Periodontal Disease With Progression of Coronary Artery Calcium in Patients With and Without Type 1 Diabetes Mellitus.
abstract: People with type 1 diabetes mellitus manifest a greater burden of both periodontal disease and coronary artery disease (CAD); however, little is known about their interrelation. Coronary artery calcium (CAC) measures subclinical atherosclerosis and predicts major adverse coronary events. The relation between periodontal disease and CAC progression in individuals with type 1 diabetes has not been previously described. We determined the prevalence and progression of CAC in relation to self-reported periodontal disease. Multivariate logistic and tobit regression models were used to examine the relation between periodontal disease duration and CAC progression and whether this relation differs by diabetes status after controlling for age, gender, total and high-density lipoprotein cholesterol, hypertension, smoking, body mass index (BMI), duration of diabetes, and baseline CAC. A total of 473 patients with type 1 diabetes and 548 without diabetes were followed for a mean of 6.1 years. At baseline, the prevalence and duration of periodontal disease did not differ between subjects with and without diabetes (14.5% vs 13.4%, p = 0.60; 6 vs 9 years, p = 0.18). Duration of periodontal disease was not significantly associated with baseline CAC prevalence. In patients with type 1 diabetes, periodontal disease duration was significantly related to CAC progression (p = 0.004) but not in subjects without diabetes (p = 0.63). In conclusion, this study suggests that periodontal disease is an independent predictor of long-term progression of CAC in patients with type 1 diabetes.
authors.affiliation: University of Colorado-Denver, Aurora, Colorado.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Groves
authors.affiliation: Denver Health Medical Center, Denver, Colorado. Electronic address: mori.krantz@dhha.org.
authors.forename: Mori J
authors.initials: MJ
authors.lastname: Krantz
authors.affiliation: University of Colorado-Denver, Aurora, Colorado; Colorado School of Public Health, Aurora, Colorado.
authors.forename: John E
authors.initials: JE
authors.lastname: Hokanson
authors.affiliation: University of Colorado-Denver, Aurora, Colorado; Colorado School of Dentistry, Aurora, Colorado.
authors.forename: Lonnie R
authors.initials: LR
authors.lastname: Johnson
authors.affiliation: University of Colorado-Denver, Aurora, Colorado.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
authors.affiliation: University of Colorado-Denver, Aurora, Colorado.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Kinney
authors.affiliation: University of Colorado-Denver, Aurora, Colorado.
authors.forename: Marian
authors.initials: M
authors.lastname: Rewers
authors.affiliation: University of Colorado-Denver, Aurora, Colorado.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Snell-Bergeon
authors.affiliation: University of South Florida, Tampa, Florida.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Alman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D018450:Disease Progression; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010510:Periodontal Diseases / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*