Relationship between Periodontal Status and Levels of Glycated Hemoglobin

Abstract

The objective of this study was to assess whether there is a bi-directional relationship between periodontal status and diabetes. Study 1 included 5,856 people without periodontal pockets of ≥ 4 mm at baseline. Relative risk was estimated for the 5-year incidence of periodontal pockets of ≥ 4 mm (CPI scores 3 and 4, with the CPI probe), in individuals with glycated hemoglobin (HbA1c) levels of ≥ 6.5% at baseline. Study 2 included 6,125 people with HbA1c < 6.5% at baseline. The relative risk was assessed for elevation of HbA1c levels in 5 years, with baseline periodontal status, assessed by CPI. Relative risk of developing a periodontal pocket was 1.17 (p = 0.038) times greater in those with HbA1c of ≥ 6.5% at baseline, adjusted for body mass index (BMI), smoking status, sex, and age. Relative risks for having HbA1c ≥ 6.5% at 5-year follow-up in groups with periodontal pockets of 4 to 5 mm and ≥ 6 mm at baseline were 2.47 (p = 0.122) and 3.45 (p = 0.037), respectively, adjusted for BMI, alcohol consumption, smoking status, sex, and age. The risk of developing periodontal disease was associated with levels of HbA1c, and the risk of elevations of HbA1c was associated with developing periodontal pockets of more than 4 mm.

Ordinal Logic Regression: A classifier for discovering combinations of binary markers for ordinal outcomes

“…It further identified two SNP interactions as associated with mild periodontitis, namely, the interaction of the recessive effect of an IL-1 α 1 SNP with, respectively, the dominant effects of an IL-1 β and an IL-10 SNP. The separate associations with periodontitis of these SNPs, smoking and HbA1c are consistent with previous reports [7, 14, 18, 23]. …”

Relationships between oral infections and blood glucose concentrations or HbA1c levels in normal and diabetic rats

“…Therefore, in alignment with previous studies, this study evaluated the levels of HbA1c 60 days after diabetes induction (Eliza et al 2009, Jain et al 2009, Civelek et al 2010). It has been reported that periodontal disease can increase HbA1c in diabetic patients (Morita et al 2012). This increase may be caused by periodontitis induction or perpetuation of an elevated systemic chronic inflammatory state (Loos 2005).…”

“…Other periodontal disease studies demonstrated that elevated HbA1c is associated with developing periodontal pockets (Ou & Li 2011, Morita et al 2012. Other periodontal disease studies demonstrated that elevated HbA1c is associated with developing periodontal pockets (Ou & Li 2011, Morita et al 2012.…”

Periodontal conditions and associated factors among adults and the elderly: findings from the first National Oral Health Survey in Uruguay

“…The common risk factor approach (CRFA) considers that oral diseases, such as periodontal diseases, share common factors with systemic non-communicable diseases and this approach allows for more efficient public health planning 10,11 . As for systemic factors, some findings suggest that patients with type I and II diabetes, obesity and stress are more prone to presenting periodontal diseases 12,13,14,15,16 . In addition, behavioral variables, such as tobacco use, dietary and hygiene habits are also associated with this condition 17,18,19 .…”