Clinical and epigenetic determinants of edentulism in type 2 diabetic subjects referring to a tertiary center

• Published in: Journal of diabetes and its complications Vol. 35; no. 5; p. 107910
• Main Authors: Parolini, Federico, Biancalana, Edoardo, Rossi, Chiara, Raggi, Francesco, Mengozzi, Alessandro, Solini, Anna
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2021; Elsevier Limited
• Subjects: Age Factors; Aged; Alzheimer's disease; Biochemistry; Blood pressure; Cardiovascular disease; Cardiovascular risk; Cohort Studies; Consciousness; Creatinine; Dental floss; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - genetics; Edentulism; Edentulous; Epigenesis, Genetic; Epigenetics; Female; Glucose; Humans; Male; MicroRNAs; Middle Aged; Mouth, Edentulous - epidemiology; Mouth, Edentulous - genetics; Oral hygiene; Patients; Periodontitis - epidemiology; Periodontitis - genetics; Questionnaires; Teeth; Type 2 diabetes; Urine; United States > US; Edentulism; Type 2 diabetes; Epigenetics; Oral hygiene; Cardiovascular risk
• ISSN: 1056-8727; 1873-460X; 1873-460X
• DOI: 10.1016/j.jdiacomp.2021.107910

Edentulism, extreme consequence of severe periodontitis, carries a high cardiovascular and all-cause death risk. The prevailing phenotype of edentulous patients with type 2 diabetes (T2D) has never been defined, neither it is known whether an epigenetic signature of such condition exists. We collected clinical and biochemical data and administered a questionnaire on oral health in 248 consecutive T2D individuals. Vital status was checked after 17 ± 7 months. miRNAs involved in periodontal inflammation were measured. Forty-seven patients (19%) were edentulous (ED), a higher prevalence than in the Italian general population (10.9% from ISTAT data). ED were older, with low level of instruction and higher fasting glucose vs not edentulous (noED). Participants displayed a scarce awareness of the association periodontitis-T2D. ED showed a specific epigenetic signature (lower miR214-5p and higher miR126-5p urinary levels). At the follow-up, metabolic profile similarly improved in ED and noED; death occurrence was similar. In this cohort of T2D, age is the only variable associated with edentulism; such condition displays an epigenetic signature, independent of the clinical phenotype; awareness of the clinical relevance and implications of periodontitis and edentulism are scarce. However, edentulism does not mark an increased rate of micro-macrovascular complications or mortality. •Edentulism is characterized by a high prevalence of CV morbidity and death.•In our cohort of T2D subjects, prevalence of edentulism is two-fold higher than in the general population.•Edentulism shows a peculiar epigenetic signature independent of the clinical phenotype.•Edentulism does not mark an increased rate of micro-macrovascular complications or mortality over a 2-year follow up.