Severe Periodontitis Is Associated with Insulin Resistance in Non-abdominal Obese Adults.
We hypothesized that insulin resistance, even with normal body weight (body mass index or waist circumference), can aggravate periodontitis severity.



We investigated the associations between diabetes, insulin resistance, and severe periodontitis.



Among 29 235 total participants, 5690 subjects aged ≥ 30 y who had periodontal disease with community periodontal index (CPI) of 3 or 4 were selected for this study.



Data were derived from the 2008-2010 Korea National Health and Nutrition Examination Survey.



Patients diagnosed with type 2 diabetes were more likely to have severe periodontitis (CPI 4) compared with patients with normal glucose tolerance or impaired fasting glucose (P < .001). Subjects with severe periodontitis had significantly higher prevalence of abdominal obesity, serum triglycerides, and insulin resistance (P values of .012, <.001, and .003, respectively). The odds ratios (ORs) for prevalence of severe periodontitis were significantly increased from normal glucose tolerance and impaired fasting glucose (OR = 1.32; 95% confidence interval, 1.06-1.64) to type 2 diabetes (OR = 1.5; 95% CI, 1.11-2.02), after adjusting for potential confounders (P for trend = .003). The prevalence of severe periodontitis increased significantly with increasing insulin resistance (P for trend = .04) in nondiabetic individuals. Furthermore, insulin-resistant individuals with normal waist circumference showed significantly higher odds of severe periodontitis (OR = 1.47; 95% CI, 1.16-1.87) than did insulin-sensitive individuals with normal waist circumference.



Non-abdominally obese subjects with insulin resistance were more likely to have severe periodontitis. Insulin resistance can be considered an independent risk factor of periodontal disease in normal weight population defined by abdominal obesity.
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
In-Seok
IS
Song
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Kyungdo
K
Han
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Yong-Moon
YM
Park
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Suk
S
Ji
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Sang Ho
SH
Jun
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Jae-Jun
JJ
Ryu
Department of Oral and Maxillofacial Surgery (I.-S.S., S.H.J.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; Department of Biostatistics, College of Medicine (K.H.), The Catholic University of Korea, Seoul 06591, Republic of Korea; Epidemiology Branch (Y.-M.P.), National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709; Department of Periodontology (S.J.), Ajou University Hospital, Suwon 16499, Republic of Korea; Department of Prosthodontics (J.-J.R.), Korea University Anam Hospital, Seoul 02841, Republic of Korea; and Department of Periodontics, College of Medicine (J.-B.P.), The Catholic University of Korea, Seoul 06591, Republic of Korea.
Jun-Beom
JB
Park
D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000453:epidemiology; D056128:Obesity, Abdominal / Q000097:blood / Q000453:epidemiology; D010512:Periodontal Index; D010518:Periodontitis / Q000097:blood* / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index
D001786:Blood Glucose