Association between periodontitis and systemic medication intake: A case‐control study

Wang, I‐Ching; Askar, Houssam; Ghassib, Iya; Wang, Chin-Wei; Wang, Hom‐Lay

doi:10.1002/jper.19-0593

Cited by 15 publications

(13 citation statements)

References 55 publications

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“…Patients with moderate or severe periodontitis (probing depth ≥4 to 5 mm) have a significantly higher risk for developing type 2 diabetes after 5 years of follow-up (RR = 2.47; 3.45). [25][26][27][28][29] Fasting blood glucose, HbA1c, and HOMA-IR values were significantly higher in patients with diabetes with severe periodontitis than in patients with diabetes alone. 30 In addition, some clinical trials showed that after nonsurgical periodontal treatment in patients with diabetes, blood glucose levels and HbA1c were significantly decreased concomitant with improved periodontal status, and the required medication dosage for managing diabetes was reduced as well.…”

Section: Discussionmentioning

confidence: 98%

“…Cross‐sectional and longitudinal studies have shown that periodontitis is a risk factor for diabetes. Patients with moderate or severe periodontitis (probing depth ≥4 to 5 mm) have a significantly higher risk for developing type 2 diabetes after 5 years of follow‐up (RR = 2.47; 3.45) 25–29 . Fasting blood glucose, HbA1c, and HOMA‐IR values were significantly higher in patients with diabetes with severe periodontitis than in patients with diabetes alone 30 .…”

Section: Discussionmentioning

confidence: 99%

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Circulating small extracellular vesicles from patients with periodontitis contribute to development of insulin resistance

Wang

Peng

et al. 2022

Journal of Periodontology

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Background Epidemiological studies have identified the role of periodontitis in the pathogenesis of type 2 diabetes, but the underlying mechanism is poorly understood. It is well‐known that small extracellular vesicles are lipid bilayer vesicles derived from cells with a diameter around 30 to 200 nm. The purpose of this study was to investigate whether periodontitis induced or exacerbated insulin resistance via circulating small extracellular vesicles. Methods Plasma small extracellular vesicles from control and periodontitis rats were intravenously injected into type 2 diabetic rats. Insulin tolerance tests, glucose tolerance tests, and the activation of the insulin signaling pathway were measured to detect the effect of the plasma small extracellular vesicles on insulin sensitivity. In addition, circulating small extracellular vesicles from patients with periodontitis with or without diabetes were isolated and co‐cultured with HepG2 cells. The ability of glucose uptake was assessed using the fluorescence of 2‐NBDG via flow cytometry. The activation of insulin signaling pathway was examined via Western blotting. Real time quantitative polymerase chain reaction (RT‐qPCR) was used to detect the expression of enzyme related to glycolysis and gluconeogenesis. Results Small extracellular vesicles derived from the plasma of periodontitis rats further impaired glucose tolerance and insulin tolerance in diabetic rats and significantly reduced the activation of the insulin signaling pathway in liver tissues, as evidenced by the decreased levels of p‐AKT and p‐GSK3β and the reduced hepatic glycogen content. For small extracellular vesicles isolated from human plasma, the concentration of small extracellular vesicles in patients with type 2 diabetes combined with periodontitis was higher than that of the healthy control and periodontitis alone. Moreover, circulating small extracellular vesicles from patients with periodontitis significantly inhibited the glucose uptake capacity and inhibited insulin signaling of HepG2 cells. Conclusion Periodontitis acted as a contributing factor to exacerbate insulin resistance of type 2 diabetic rats. Plasma small extracellular vesicles played a critical role in periodontitis aggravating insulin resistance.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Circulating small extracellular vesicles from patients with periodontitis contribute to development of insulin resistance

Wang

Peng

et al. 2022

Journal of Periodontology

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“…8,9 It is well-documented that periodontal disease is a complex disease with multiple potential contributing factors. These include genetic 10 and epigenetic influences, 11 medication use 12 and/or environmental factors, 13 which together promote periodontal disease initiation and progression. Low socioeconomic status, poor oral hygiene, and oral health related behaviors, psychological stress, and/or depression, increased age, ethnicity, diet/obesity, and systemic health comorbidities are risk factors that contribute to the prevalence of periodontal diseases.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, extent, and severity of periodontitis among Australian older adults: Comparison of two generations

Harford

Luzzi

et al. 2022

Journal of Periodontology

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Background Chronic periodontitis is highly prevalent among older adults. The study aimed to compare periodontal disease among Australian older adults in two generations. We hypothesized that the prevalence and severity of periodontitis would decrease from the previous generation to the recent generation. Methods Data were obtained from the South Australian Dental Longitudinal Study (SADLS) in 1991 to 1992 (SADLS I) and 2013 to 2014 (SADLS II); population‐based longitudinal surveys of Australian older adults aged ≥60 years. American Academy of Periodontology, the US Centers for Disease Control and Prevention (AAP/CDC), and the 2018 European Federation of Periodontology (EFP/AAP) classification case definitions were used to define and calculate prevalence of chronic periodontitis. Multivariable log‐Poisson regression models were used to identify risk indicators for severe periodontitis after adjusting for other covariates. Results There were a total of 801 and 355 participants that underwent a periodontal exam in SADLS I and II, respectively. The prevalence of severe periodontitis was higher in the recent generation (88% and 56%) than the previous generation (75% and 46.7%) under the CDC/AAP and EFP/AAP case definitions, respectively. The mean number of missing teeth was lower in the recent generation (6) than the previous generation (13). The prevalence ratio of severe periodontitis was around two times higher in the younger age group, men, those not born in Australia, and current smokers across both generations. Conclusions Our findings indicated that the recent generation of older adults has higher prevalence and severity of chronic periodontitis than the previous generation. Our findings indicated that aging, being male, born overseas, low household income, no dental insurance, and being a current smoker are significant risk factors associated with severe periodontitis among older Australians.

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“…However, this study only assessed the presence of hypertension without recording the data on medication, thus the association can not be ruled out from the influence of medication side effects. Besides that, the current literature remains inconclusive regarding the effect of medications, as with no or positive associations are reported conclusively [25]. Such as, thiazide-like diuretic, which is one of the first line antihypertensive therapies, contributes to the development of periodontal disease [26] by reduced salivary rate and composition [27].…”

Section: Discussionmentioning

confidence: 99%

Severity and progression rate of periodontitis are associated with an increased risk of hypertension of patients attending a university clinic

et al. 2022

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Background Although periodontitis is associated with increased risk of hypertension, studies based on new periodontal disease classification is limited. We investigated whether periodontitis severity and progression rate are linked with self-reports on doctor-diagnosed hypertension in a large cohort of patients attending the periodontology clinic at the faculty of dentistry. Methods Archived patient files, including radiographic image records and results from full-mouth clinical periodontal examination were screened for inclusion. Data on socioeconomic factors, smoking and oral hygiene habits, and medical history were collected with a questionnaire. Results Diagnosis and background data were available for 7008 patients. The median (IQR) age was 31.0 (21.0) years; 60.1% (n = 4211) were female. Hypertension was diagnosed in 6.2% (n = 435) of patients. Both periodontitis stage and grade differed (p < 0.001) between patients with or without hypertension. Increased periodontal disease severity was associated with a 20% increasing risk for hypertension; the odds ratio (OR) was 2.63 (95% confidence interval [CI] 1.48–4.68, p < 0.001) in stage IV periodontitis. Increasing periodontitis progression rate was associated with a 35% increased risk for hypertension; the OR was 2.22 (95% CI 1.45–3.40, p < 0.001) in grade C periodontitis. Conclusion Severity and progression rate of periodontitis may be independent risk factors for hypertension in this large cohort of patients attending the university periodontal department.

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Association between periodontitis and systemic medication intake: A case‐control study

Cited by 15 publications

References 55 publications

Circulating small extracellular vesicles from patients with periodontitis contribute to development of insulin resistance

Circulating small extracellular vesicles from patients with periodontitis contribute to development of insulin resistance

Prevalence, extent, and severity of periodontitis among Australian older adults: Comparison of two generations

Severity and progression rate of periodontitis are associated with an increased risk of hypertension of patients attending a university clinic

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