Association of periodontitis with insulin resistance, &amp;beta;-cell function, and impaired fasting glucose before onset of diabetes

Islam, Soriful; Seo, Minchul; Lee, Young-Sil; Moon, Seong-Su

doi:10.1507/endocrj.ej15-0350

Cited by 49 publications

(44 citation statements)

References 44 publications

(45 reference statements)

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“…Choi et al 20 reported that chronic periodontitis measured by clinical attachment loss and pocket depth was positively associated with IFG and diabetes in a dose-dependent manner in the US population. Another study using data from periodic medical examinations for 815 nondiabetic adults showed that the prevalence of alveolar bone loss was higher among individuals with a FPG level ≥100 mg/dL versus <100 mg/dL ( P = 0.032) 18 Similarly, Islam et al 24 reported an increased prevalence of IFG before the onset of diabetes in patients with periodontitis, compared with subjects without periodontitis, and vice versa (28.5% vs 17.7%).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults

2016

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Although the relationship between diabetes and periodontitis is well established, the association between periodontitis and prediabetes has been investigated less extensively. Furthermore, there has been little research on the prevalence of periodontitis among individuals with prediabetes and diabetes as well as in the overall population using nationally representative data.Among 12,406 adults (≥19 years’ old) who participated in the 2012–2013 Korea National Health and Nutrition Examination Survey, a total of 9977 subjects completed oral and laboratory examinations and were included in this analysis. Periodontitis was defined as a community periodontal index score of ≥3 according to the World Health Organization criteria. The fasting plasma glucose level was categorized into the following 5 groups: normal fasting glucose (NFG) 1 (<90 mg/dL), NFG 2 (90–99 mg/dL), impaired fasting glucose (IFG) 1 (100–110 mg/dL), IFG 2 (111–125 mg/dL), and diabetes (≥126 mg/dL).Overall, the weighted prevalence of periodontitis among the Korean adult population was 24.8% (23.3–26.4%) (weight n = 8,455,952/34,086,014). The unadjusted weighted prevalences of periodontitis were 16.7%, 22.8%, 29.6%, 40.7%, and 46.7% in the NFG 1, NFG 2, IFG 1, IFG 2, and diabetes groups, respectively (P < 0.001). After adjusting for age, sex, smoking history, heavy alcohol drinking, college graduation, household income, waist circumference, serum triglyceride level, serum high-density lipoprotein cholesterol level, and the presence of hypertension, the adjusted weighted prevalence of periodontitis increased to 29.7% in the IFG 2 group (P = 0.045) and 32.5% in the diabetes group (P < 0.001), compared with the NFG 1 group (24%). The odds ratios for periodontitis with the above-mentioned variables as covariates were 1.42 (95% confidence interval [CI] 1.14–1.77, P = 0.002) in the diabetes group and 1.33 (95% CI 1.01–1.75, P = 0.044) in the IFG 2 group, respectively, compared with the NFG1 group.In conclusion, a higher range of IFG levels as well as diabetes, were positively associated with chronic periodontitis in a representative sample of Korean adults. This study suggests that individuals with a higher range of IFG levels before diabetes are at risk of periodontitis, and may benefit from dental screening.

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Section: Discussionmentioning

confidence: 99%

The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults

2016

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“…Few cross-sectional studies (Arora et al, 2014; Choi et al, 2011; Hong et al, 2016; Islam et al, 2015; Song et al, 2016) and only three longitudinal studies (Chiu et al, 2015; Demmer et al, 2010; Saito et al, 2004) have found significant associations between prediabetes states and periodontitis. However, other cross-sectional studies have found no association between prediabetes states and periodontitis (Arora et al, 2014; Demmer et al, 2015; Kowall et al, 2015; Noack et al, 2000; Saito et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

“…A pilot case-control study found that mean HbA1c was significantly higher in periodontitis cases than in healthy controls (Wolff et al, 2009). The insulin resistance-periodontitis association has been investigated in six cross-sectional studies (Song et al, 2016; Demmer et al, 2012; Islam et al, 2015; Benguigui et al, 2010; Lim et al, 2014; Timonen et al, 2011) and one longitudinal study (Timonen et al, 2013) and have produced mixed results. The one-hour post-load plasma glucose (1hPG) concentration during the oral glucose tolerance test has been shown to correlate strongly with predictors of diabetes and abnormal glucose homeostasis (Abdul-Ghani et al, 2008; Joshipura et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Cross‐sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis

Pérez

Muñoz

Andriankaja

et al. 2017

J Clinic Periodontology

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Aim This study assessed the associations of prediabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults. Materials and methods We included 1,191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in the San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated hemoglobin. 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. Results After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, prediabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; prediabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers. Conclusions This study suggests associations between prediabetes 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 are of utmost importance.

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“…We also measured the following laboratory parameters at 0 min: hemoglobin, aspartate transaminase, alanine transaminase, serum creatinine, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, serum uric acid, and HbA1c levels. To evaluate insulin secretion capacity and insulin resistance, we performed the following calculations [1, [5][6][7]: UGE (mg) = urinary glucose (mg/dL) × urine volume (dL); insulinogenic index = (Δinsulin 0-30 min) / (ΔPG 0-30 min); homeostasis model assessment of β-cell function (HOMA-β) = 360 × fasting insulin (μU/mL) / [FPG (mg/dL) -63]; homeostasis model assessment of insulin resistance (HOMA-IR) = FPG (mg/dL) × fasting insulin (μU/mL) / 405. Insulinogenic index and HOMA-β are indicators of insulin secretion capacity, and HOMA-IR is an indicator of insulin resistance.…”

Section: Sodium-glucosementioning

confidence: 99%

Usefulness of urinary glucose excretion after oral glucose tolerance testing to detect insulin secretion failure before the onset of diabetes mellitus

Ono

Hinata

et al. 2017

Endocr J

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Abstract. Sodium-glucose cotransporter 2 inhibitors are commonly used to promote urinary glucose excretion (UGE). However, it remains unclear how UGE reflects glucose metabolism in the natural history of diabetes. Thus, we retrospectively reviewed the prediabetes medical records of 64 patients who had undergone 75-g oral glucose tolerance testing (OGTT) with measurements of UGE at 0 min, 60 min, and 120 min. The mean age and glycated hemoglobin levels were 46 ± 10 years and 5.6 ± 0.3%, respectively. The median UGE (60 min + 120 min) value was 16.8 mg ( The log-transformed insulinogenic index exhibited a significant inverse association with log-transformed UGE (60 min + 120 min) (r = -0.50, p < 0.001). The association between higher UGE and lower insulinogenic index was also observed in a subgroup analysis of patients with plasma glucose levels of ≥160 mg/ dL during the OGTT. Therefore, UGE measurements after OGTT may provide a useful clinical marker for detecting insulin secretion failure and advancing preventive and therapeutic interventions among populations with a high risk of developing diabetes.

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Association of periodontitis with insulin resistance, β-cell function, and impaired fasting glucose before onset of diabetes

Cited by 49 publications

References 44 publications

The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults

The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults

Cross‐sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis

Usefulness of urinary glucose excretion after oral glucose tolerance testing to detect insulin secretion failure before the onset of diabetes mellitus

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