Subgingival microbiome in periodontitis and type 2 diabetes mellitus: an exploratory study using metagenomic sequencing

Lu, Xianjun; Liu, Tingjun; Zhou, Jianchang; Liu, Jia; Yuan, Zijian; Guo, Lihong

doi:10.5051/jpis.2103460173

Cited by 10 publications

(6 citation statements)

References 40 publications

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“…Chronic inflammation, which is common in both periodontitis and prediabetes, is a commonly cited mechanism linking these conditions (Preshaw et al, 2012). Indeed, periodontal pathogens express virulence factors that may enhance local and systemic inflammation, and several prior studies have reported periodontitis to be associated with increased biomarkers of systemic inflammation (Hajishengallis, 2015; Lu et al, 2022). Multiple randomized controlled trials have demonstrated that periodontal therapy to effectively reduce systemic inflammation, consistent with an improvement in clinical periodontal measures (Baeza et al, 2020; Stöhr et al, 2021; Teeuw et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Clinical attachment loss is cross‐sectionally associated with elevated glucose among adults without diabetes

Adam,

Molinsky,

Bohn

et al. 2024

J Clinic Periodontology

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AimWe investigated whether periodontal measures are cross‐sectionally associated with prediabetes and cardiometabolic biomarkers among non‐diabetic younger adults.Materials and MethodsOne thousand seventy‐one participants (mean age = 32.2 years [SE = 0.3]; 73% female) from the Oral Infections, Glucose Intolerance and Insulin Resistance Study were enrolled. Full‐mouth clinical attachment loss (fm‐CAL), probing depth (fm‐PD) and bleeding on probing were ascertained. Interproximal CAL (i‐CAL) and probing depths (i‐PD) served as our primary exposures. Glucose, HbA1c, insulin and insulin resistance (HOMA‐IR) outcomes were assessed from fasting blood. Prediabetes was defined per American Diabetes Association guidelines. Prediabetes prevalence ratios (PR [95% CI]) and mean [SE] cardiometabolic biomarkers were regressed on periodontal variables via multivariable robust variance Poisson regression or multivariable linear regression.ResultsPrevalence of prediabetes was 12.5%. Fully adjusted prediabetes PR in Tertiles 3 versus 1 of mean i‐CAL was 2.42 (1.77, 3.08). Fully adjusted fasting glucose estimates across i‐CAL tertiles were 83.29 [0.43], 84.31 [0.37], 86.48 [0.46]; p for trend <.01. Greater percent of sites with i‐PD ≥3 mm showed elevated natural‐log‐HOMA‐IR after adjustment (0%–12% of sites = 0.33 [0.03], 13%–26% of sites = 0.39 [0.03], ≥27% of sites = 0.42 [0.03]; p for trend = .04).Conclusionsi‐CAL (vs. fm‐CAL) was associated with elevated fasting glucose and prediabetes, whereas i‐PD (vs. fm‐PD) was associated with insulin resistance. Future studies are needed to examine periodontal disease and incident prediabetes.

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Section: Discussionmentioning

confidence: 99%

Clinical attachment loss is cross‐sectionally associated with elevated glucose among adults without diabetes

Adam,

Molinsky,

Bohn

et al. 2024

J Clinic Periodontology

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“…Hyperglycemia leads to inflammatory response disturbances ( 42 ), enhancing pro-inflammatory cytokines and matrix metalloproteinases (MMP) expression ( 35 ), so the periodontal tissue metabolism adversely affects blood vessels and promotes periodontitis, which develops more rapidly and more intensely ( 43 ), with hyperglycemia enhancing its progression ( 44 , 45 ), even at pre-DM levels ( 46 ). Importantly, hyperglycemia severity, not the DM diagnosis, affects the periodontium ( 47 , 48 ).…”

Section: Periodontal Diseasesmentioning

confidence: 99%

Current scientific evidence for why periodontitis should be included in diabetes management

Borgnakke

2024

Front. Clin. Diabetes Healthc.

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This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment (“deep cleaning”) can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation – especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth – has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with – or at risk for – hyperglycemia.

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“…T2DM patients are more susceptible to periodontal pathogens and have a higher risk of periodontitis ( 62 ). The metabolism of galactose, mannose, and fructose, the mutual conversion of glucuronic acid and pentose, and the pathways of glycolysis may represent a potential microbial association between diabetes and periodontitis, and butyric acid is important in the interaction between them, affecting the bacterial secretion system and leading to a higher risk of periodontitis in T2DM patients ( 70 ). In periodontitis patients with or without diabetes mellitus, four microbial functional pathways associated with cell motility and signal transduction of virulence factors were enriched ( 62 ).…”

Section: The Plausible Pathogenic Mechanisms Of Diabetes Mellitus On ...mentioning

confidence: 99%

Diabetes mellitus promotes susceptibility to periodontitis—novel insight into the molecular mechanisms

Zhao,

Xie,

Gao

et al. 2023

Front. Endocrinol.

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Diabetes mellitus is a main risk factor for periodontitis, but until now, the underlying molecular mechanisms remain unclear. Diabetes can increase the pathogenicity of the periodontal microbiota and the inflammatory/host immune response of the periodontium. Hyperglycemia induces reactive oxygen species (ROS) production and enhances oxidative stress (OS), exacerbating periodontal tissue destruction. Furthermore, the alveolar bone resorption damage and the epigenetic changes in periodontal tissue induced by diabetes may also contribute to periodontitis. We will review the latest clinical data on the evidence of diabetes promoting the susceptibility of periodontitis from epidemiological, molecular mechanistic, and potential therapeutic targets and discuss the possible molecular mechanistic targets, focusing in particular on novel data on inflammatory/host immune response and OS. Understanding the intertwined pathogenesis of diabetes mellitus and periodontitis can explain the cross-interference between endocrine metabolic and inflammatory diseases better, provide a theoretical basis for new systemic holistic treatment, and promote interprofessional collaboration between endocrine physicians and dentists.

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Subgingival microbiome in periodontitis and type 2 diabetes mellitus: an exploratory study using metagenomic sequencing

Cited by 10 publications

References 40 publications

Clinical attachment loss is cross‐sectionally associated with elevated glucose among adults without diabetes

Clinical attachment loss is cross‐sectionally associated with elevated glucose among adults without diabetes

Current scientific evidence for why periodontitis should be included in diabetes management

Diabetes mellitus promotes susceptibility to periodontitis—novel insight into the molecular mechanisms

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