Periodontitis and incident type 2 diabetes: a prospective cohort study

Abstract

Objectives:To investigate periodontitis as a risk factor for incident type 2 diabetes mellitus (T2DM) in a group of men aged 58-72 years. Accepted ArticleThis article is protected by copyright. All rights reserved. Methods:1331 dentate, diabetes-free males in Northern Ireland underwent a detailed periodontal examination during [2001][2002][2003]. Follow-up was by bi-annual questionnaire and for those reporting diabetes their general medical practitioner was contacted to validate diabetes type, treatment and diagnosis date. Cox's proportional hazard models were used to estimate the effect of periodontitis on incident diabetes. Multivariable analysis included adjustment for various known confounders. Results:The mean age of the men was 63.7 (SD 3.0) years. There were 80 cases (6.0%) of incident T2DM. Follow-up was for a median period of 7.8 years ). After adjusting for confounding variables, the hazard ratio (HR) for incident T2DM in men with moderate / severe periodontitis versus those with no / mild periodontitis was 1.69 (95% CI 1.06-2.69), p=0.03. Conclusion:There was evidence in this homogenous group of dentate men, that those with moderate to severe periodontitis had a significantly increased risk of incident T2DM. Clinical Relevance Scientific rational for the study:Evidence supporting the role of chronic periodontitis as a putative risk factor for the development of type 2 diabetes mellitus (T2DM) is currently limited. Principal findings: Accepted ArticleThis article is protected by copyright. All rights reserved.This study showed that in a group of 58-72 year-old Caucasian dentate men in Northern Ireland, baseline moderate to severe periodontitis was an independent risk predictor for the development of T2DM. This relationship was independent of known confounders. Practical implications:Dentists should be aware of the potential systemic health implications of patients presenting with moderate to severe periodontitis. Patients who present with obvious risk factors for T2DM and signs of periodontitis should be informed about their risk for developing T2DM.

Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

“…Figure 1 showed the searching and including process. Appendix Table S1 and S2 summarized the characteristics of 43 cross-sectional studies and 12 [62,23,[63][64][65][66][67][68]39,[69][70][71] cohort studies, respectively. All included cross-sectional studies and cohort studies were scored more than 3.…”

Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations

“…Hence, DM represents an enormous public health challenge and is by far the principal systemic disease affecting periodontitis in terms of extent of population affected. In addition, there is accumulating evidence that periodontal inflammation may itself contribute to the onset and persistence of hyperglycemia, in that inflammation is associated with poorer glycemic control in individuals with DM and may be associated with an increase in incident DM in longitudinal prospective studies …”

“…health challenge and is by far the principal systemic disease affecting periodontitis in terms of extent of population affected. In addition, there is accumulating evidence that periodontal inflammation may itself contribute to the onset and persistence of hyperglycemia, in that inflammation is associated with poorer glycemic control in individuals with DM and may be associated with an increase in incident DM in longitudinal prospective studies 50. Chronic hyperglycemia has direct and indirect detrimental effects on multiple organs and is implicated in the development and progression of diabetic micro-and macroangiopathy 51,52.…”

Exposure to occupational noise and periodontitis in Korean workers

“…4 Risk factors for periodontitis in adulthood are numerous and include inherited factors, sex, age, diabetes, socioeconomic status, smoking, reduced immune response, insulin resistance, and poor oral hygiene. [5][6][7][8][9][10] Noise exposure is a common occupational hazard in the world. 11 Based on 1999 to 2004 data from the National Health and Nutrition Examination Survey, the National Institute for Occupational Safety and Health estimated that more than 22 million workers in the United States were potentially exposed to hazardous noise, at least briefly, at work, and that one in four workers so exposed at least occasionally to such noise did not use hearing protection devices.…”