title: Periodontitis is associated with diabetic retinopathy in non-obese adults.
abstract: OBJECTIVE
  Patients with diabetes retinopathy appear to show increased susceptibility to periodontal disease. This study was performed to assess the relationship between periodontitis and the prevalence of diabetic retinopathy in a large probability sample of the Korean population. A subgroup analysis was performed using body mass index <25 kg/m2as the criterion to evaluate the effect of obesity on this relationship.
  
  
  METHODS
  This study is based on data from the Korean National Health and Nutrition Examination Survey of the Korean population, conducted between 2008 and 2010. The presence of diabetic retinopathy in relation to demographic variables and anthropometric characteristics of the participants is presented as means with their standard errors. The presence of periodontitis and presence of retinopathy categorized by body mass index (<25 and ≥25 kg/m2) were evaluated. Multiple logistic regression analyses were used to assess the associations between periodontitis and diabetic retinopathy after adjustment with variables, including age, sex, smoking, drinking, exercise, hypertension, metabolic syndrome, HbA1c, and duration of diabetes mellitus.
  
  
  RESULTS
  There was a statistically significant increase in the prevalence of periodontitis in individuals who had proliferative diabetic retinopathy. The odds ratios [95% confidence intervals] of prevalence of diabetic retinopathy were 1.193 [0.757-1.881] for the whole population after adjustments with confounding factors. Subgroup analysis after adjustments with confounding factors showed that the odds ratios [95% confidence intervals] of prevalence were 2.206 [1.114-4.366] and 0.588 [0.326-1.061] among participants with body mass index <25 kg/m2and body mass index 37 ≥25 kg/m2, respectively.
  
  
  CONCLUSIONS
  The diabetic retinopathy was positively associated with the presence of periodontitis in non-obese diabetic Korean adults after adjustment with confounding variables. Our findings suggest that when a periodontist finds the presence of periodontitis in non-obese diabetic patients, timely evaluation of the patient's ophthalmic evaluation should be 44 recommended.
authors.affiliation: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Su Jeong
authors.initials: SJ
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seong-Su
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kyungdo
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. jbassoonis@yahoo.co.kr.
authors.forename: Jun-Beom
authors.identifier: http://orcid.org/0000-0002-8915-1555
authors.initials: JB
authors.lastname: Park
mesh_terms: D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D010518:Periodontitis / Q000453:epidemiology*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
keywords: Diabetes mellitus; Diabetic retinopathy; Epidemiology; Health surveys; Periodontitis