Journal article
Periodontitis and Risk of Diabetes in the Atherosclerosis Risk In Communities (ARIC) Study: A BMI-Modified Association
The journal of clinical endocrinology and metabolism, Vol.106(9), pp.E3546-E3558
09/01/2021
DOI: 10.1210/clinem/dgab337
PMCID: PMC8372648
PMID: 33982107
Abstract
Purpose: To determine whether periodontal disease is positively associated with incident diabetes across the continuum of body mass levels (BMI) and test the hypothesis that the periodontal risk for incident diabetes is modified by BMI.
Methods: We included 5569 diabetes-free participants from Visit 4 (1996-1998) of the Atherosclerosis Risk in Communities study and followed them until 2018. Periodontal disease status was classified by periodontal profile class (PPC)-Stages , and incident diabetes was based on participant report of physician diagnosis. We estimated the hazard ratios (HR) for diabetes using a competing risk model for each PPC-Stage. We assessed multiplicative interactions between periodontal disease and BMI (as a continuous variable) on risk of diabetes.
Results: During a median time of 19.4 years of follow-up, 1348 incident diabetes cases and 1529 deaths occurred. Compared to the "Health/Incidental Disease" stage, participants with PPC "Severe Periodontal Disease" or "SevereTooth Loss" stage and lower BMI had elevated risk for diabetes adjusting for demographic, smoking, education, and biological variables when accounting for death as a competing risk with HRs of 1.76 (95% CI 1.10-2.80) and 2.11 (95% CI 1.46-3.04), respectively. The interaction between PPC-Stages and BMI was significant (P = 0.01). No significant associations of PPC-Stages with incident diabetes were present when BMI was above 31 kg/m(2).
Conclusion: Periodontal disease was associated with incident diabetes, especially in nonobese participants. Dentists should be aware that periodontal disease is associated with incident diabetes but the association may be modified for patient's at higher BMI levels.
Details
- Title: Subtitle
- Periodontitis and Risk of Diabetes in the Atherosclerosis Risk In Communities (ARIC) Study: A BMI-Modified Association
- Creators
- Shaoping Zhang - University of IowaKamaira H. Philips - University of North Carolina at Chapel HillKevin Moss - University of North Carolina at Chapel HillDi Wu - University of North Carolina at Chapel HillHamdi S. Adam - University of MinnesotaElizabeth Selvin - Johns Hopkins UniversityRyan T. Demmer - University of MinnesotaFaye L. Norby - University of MinnesotaIndra Z. Mustapha - Howard UniversityJames D. Beck - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- The journal of clinical endocrinology and metabolism, Vol.106(9), pp.E3546-E3558
- DOI
- 10.1210/clinem/dgab337
- PMID
- 33982107
- PMCID
- PMC8372648
- NLM abbreviation
- J Clin Endocrinol Metab
- ISSN
- 0021-972X
- eISSN
- 1945-7197
- Publisher
- Endocrine Soc
- Number of pages
- 13
- Grant note
- HHSN268201700001I; HHSN268201700002I; HHSN268201700003I; HHSN268201700005I; HHSN268201700004I / National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) 4R00DE027086 / National Institute of Dental and Craniofacial Research (NIDCR) R00 grant
- Language
- English
- Date published
- 09/01/2021
- Academic Unit
- Periodontics
- Record Identifier
- 9984367749902771
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