Association between Serum Antibodies to Oral Microorganisms and Hyperglycemia in Adults

Abstract

We conducted a cross-sectional analysis to evaluate the relationship between serum antibody titers against 19 selected oral microorganisms and measures of hyperglycemia in a large, nationally representative data set. The study population consisted of 7,848 participants from the National Health and Nutrition Examination Survey III (1988-1994) who were at least 40 yrs old, with complete serum IgG antibody data against 19 oral microorganisms. The 19 antibody titers were grouped into 4 categories via cluster analysis--orange-red, yellow-orange, orange-blue, and red-green--named to reflect predominant antibody titers against microorganisms in Socransky's classification scheme for oral microbes. Linear regression models weighted for complex survey design were used in which fasting blood glucose, fasting insulin, and HbA1c were outcomes and antibody cluster scores were exposures, adjusting for potential confounders. Higher orange-red cluster scores were associated with increased hyperglycemia, while higher orange-blue cluster scores were related with decreased hyperglycemia. A 1-unit-higher orange-red cluster score was associated with 0.46 mg/dL higher fasting blood glucose (p = .0038), and a 1-unit-higher orange-blue cluster score was associated with 0.34% lower HbA1c (p = .0257). Groups of antibody titers against periodontal microorganisms were associated with hyperglycemia independent of known risk factors.

Association Between Serum Antibodies to Periodontal Bacteria and Rheumatoid Factor in the Third National Health and Nutrition Examination Survey

“…The authors identified the following four mutually exclusive clusters and named them using the commonly used color coding for periodontal bacteria (39): i) orange-blue ( Eubacterium nodatum, Actinomyces naeslundii ), ii) yellow-orange ( Streptococcus intermedius, Streptococcus oralis, Streptococcus mutans, Fusobacterium nucleatum, Parvimonas micros (previously Micromonas micros), Capnocytophaga ochracea ), iii) red-green ( Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans mix, Eikenella corrodens, Selenomonas noxia, Veillonella parvula, Campylobacter rectus ), and iv) orange-red ( Prevotella melaninogenica, Prevotella intermedia, Prevotella nigrescens, Porphyromonas gingivalis mix ) clusters (38). Cluster scores were created from the sum of the natural log transformed values of antibody levels for each species in the cluster to form continuous measures.…”

Cross‐sectional association of physical activity and periodontal antibodies

“…We classified antibody clusters using serum IgG antibody titer values among NHANES III participants . Briefly, each of the 19 serum IgG antibody titer values were natural log transformed and standardized by dividing by the log transformed population standard deviation.…”

“…The cluster scores were calculated for every participant. The outcomes were the sum of the z‐scores for each of the clusters …”

“…In this study, we evaluated the relation between groups of IgG antibodies against 19 oral microorganisms and physical activity. We hypothesized that physical activity would be associated with a higher level of antibodies associated with a healthy periodontal state because we previously reported that this group of antibodies was inversely associated with hyperglycemia . To the best of our knowledge, the relation between physical activity and periodontal microorganisms or their antibody levels has not been evaluated.…”

“…The advantage of evaluating IgG antibodies against periodontal microorganisms is that they remain elevated for a long time after treatment, thereby reflecting periodontal disease history . Also, clustering the antibody titers may reflect how microorganisms group together in the mouth . This analysis will help clarify complex mechanisms surrounding physical activity and periodontal health.…”