Association Between the Severity of Periodontitis and Osteoarthritis in Middle‐Aged and Older Patients With Type 2 Diabetes Mellitus: A Nationwide Population‐Based Study

Abstract

Objective. Periodontitis and osteoarthritis are major public health concerns that result in decreased quality of life among middle-aged and older adults. We sought to examine whether the severity of periodontitis is related to osteoarthritis according to the presence of type 2 diabetes mellitus.Methods. This study included 3,527 participants age ≥50 years from the Korean National Health and Nutrition Examination Survey. Periodontitis was assessed using the Community Periodontal Index; severe periodontitis was defined as periodontal tissue forming deep periodontal pockets ≥6-mm depth. Osteoarthritis was defined as Kellgren/Lawrence grade ≥2 on radiographic images of the knee or hip area with joint pain. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for osteoarthritis according to the severity of periodontitis, stratified by type 2 diabetes mellitus, were calculated using multiple logistic regression analyses.Results. Participants with type 2 diabetes mellitus were more likely to have osteoarthritis as the severity of periodontitis increased (nonsevere periodontitis OR 1.23 [95% CI 0.67-2.32]; severe periodontitis OR 3.01 [95% CI 1.51-5.84]) after adjusting for age, sex, body mass index, smoking status, alcohol consumption, regular exercise, education level, household income, hypertension, and frequent tooth-brushing. However, this positive association was not found in individuals without type 2 diabetes mellitus after adjusting for the same covariables.Conclusion. Severe periodontitis was positively and significantly associated with osteoarthritis in middle-aged and older individuals with type 2 diabetes mellitus. Our findings suggest that the oral inflammation manifesting in periodontitis may be at least partly involved in the pathogenesis of osteoarthritis, particularly in patients with type 2 diabetes mellitus.

Cross-Tissue Analysis Using Machine Learning to Identify Novel Biomarkers for Knee Osteoarthritis

“…Other studies have shown that periodontitis is associated with the presence and severity of KOA [ 58 ]. It has been concluded that periodontitis is at least partly involved in the pathogenesis of OA, especially in patients with type 2 diabetes [ 59 ].…”

Classifying Integrated Signature Molecules in Macrophages of Rheumatoid Arthritis, Osteoarthritis, and Periodontal Disease: An Omics-Based Study

“…However, most of the research is concentrated on one disease at a time [ 54 , 55 ]. Recent advances in the study of RA and PD, OA and PD, RA and OA, as well as RA, OA, and PD separately, have been made by utilizing the data generated from high-throughput technologies (DNA microarrays and RNAseq), and Omics-based techniques [ 5 , 6 , 8 , 16 , 20 , 37 , 39 , 56 , 57 , 58 ]. However, their applicability is limited when it comes to identifying integrated signature molecules for RA, OA, and PD together.…”

“…The majority of research connects OA to low-grade inflammation and mechanical stress, including accidents, aging, obesity, etc. Recent research, however, indicates that different kinds of inflammation may play a key role in the emergence of OA [ 3 , 4 , 5 , 6 ]. A study [ 7 ] found a correlation between the severity of OA and rising levels of systemic inflammatory markers, such as lipopolysaccharides (LPS) produced by bacteria.…”

Effect of osteoarthritis on alveolar bone loss in experimental periodontitis in rats

“…In contrast, the association was not significant in non-diabetic subjects. 42 There is also evidence that periodontal pathogens may be a possible etiologic factor of both RA and osteoarthritis. DNA of periodontal bacteria, mainly Fusobacterium nucleatum, was identified in synovial fluid samples taken from failed prosthetic joints of 14% of arthritis patients.…”