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

• Published in: Journal of clinical periodontology Vol. 51; no. 5; pp. 522 - 535
• Main Authors: Adam, Hamdi S., Molinsky, Rebecca, Bohn, Bruno, Roy, Sumith, Rosenbaum, Michael, Paster, Bruce, Yuzefpolskaya, Melana, Colombo, Paolo C., Papapanou, Panos N., Desvarieux, Moïse, Jacobs, David R., Demmer, Ryan T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2024
• Subjects: Adult; Adults; Biomarkers; Blood Glucose; Cardiovascular Diseases; Cross-sectional studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Epidemiology; Fasting; Female; Glucose; Glucose tolerance; Glycated Hemoglobin; HbA1c; Humans; insulin; Insulin Resistance; Male; Metabolism; Periodontal diseases; Periodontics; periodontitis; prediabetes; Prediabetic State - epidemiology; Regression analysis; epidemiology; glucose; insulin; biomarkers; prediabetes; periodontitis; HbA1c
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.13945

Aim We investigated whether periodontal measures are cross‐sectionally associated with prediabetes and cardiometabolic biomarkers among non‐diabetic younger adults. Materials and Methods One 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. Results Prevalence 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). Conclusions i‐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.