title: Cross-sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis.
abstract: This study assessed the associations of pre-diabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults.
  
  
  
  We included 1191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated haemoglobin. Impaired one-hour plasma glucose (1hPG) was defined as levels >155 mg/dl. Insulin resistance was defined using the study population-specific 75th percentile (HOMA-IR ≥ 3.13). High BOP was defined as percentage of teeth with bleeding ≥30%. Periodontitis was defined according to the CDC/AAP definition.
  
  
  
  After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, pre-diabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; pre-diabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers.
  
  
  
  This study suggests associations between pre-diabetes and insulin resistance with BOP and periodontitis. Given the high prevalence of impaired glucose metabolism and periodontitis, the assessment of the temporal sequence of these associations is of utmost importance.
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Francisco
authors.initials: F
authors.lastname: Muñoz
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Oelisoa M
authors.initials: OM
authors.lastname: Andriankaja
authors.affiliation: San Francisco Veterans Affairs Medical Center, Center for Research on Aging at the Jewish Home of San Francisco, San Francisco, CA, USA.
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Sasha
authors.initials: S
authors.lastname: Martínez
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: José
authors.initials: J
authors.lastname: Vergara
authors.affiliation: School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: José
authors.initials: J
authors.lastname: Vivaldi
authors.affiliation: School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Lydia
authors.initials: L
authors.lastname: López
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Maribel
authors.initials: M
authors.lastname: Campos
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.
authors.forename: Kaumudi J
authors.identifier: 0000-0003-1964-7579
authors.initials: KJ
authors.lastname: Joshipura
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D018149:Glucose Intolerance / Q000150:complications*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications* / Q000453:epidemiology
keywords: bleeding on probing; impaired fasting glucose; impaired glucose tolerance; impaired glycated haemoglobin; insulin resistance; periodontitis; pre-diabetes