OBJECTIVES Although previous studies have demonstrated an association between periodontal disease (PD) and diabetes mellitus (DM), the influence of age and the mediating role of inflammation have seldom been explored. This study investigated this association while considering the modifying effects of age and inflammatory status.
METHODS
This study included 29,491 participants from the 2012-2018 Korea National Health and Nutrition Examination Survey. The community periodontal index (CPI) was assessed by trained dentists using the World Health Organization CPI probe. PD was defined as a CPI score of 3 or 4. Pre-existing and incident DM were identified based on serum glucose levels, a history of DM diagnosis, medication use, and insulin injections. Serum high-sensitivity C-reactive protein (hs-CRP) levels were utilized as an indicator of chronic inflammation.
RESULTS
PD and DM exhibited a significant association, which was more pronounced with incident DM than with pre-existing DM, particularly in individuals younger than 65 years. Among those aged 20-44 years, the odds ratio of incident DM for CPI=4 versus CPI=0 was 2.61 (95% confidence interval, 1.16 to 6.09). High hs-CRP levels (>3 mg/L) were also associated with DM, especially in individuals with PD. This association was stronger with incident DM than with pre-existing DM. A notable joint effect was observed in younger individuals and those with PD.
CONCLUSIONS
The association between PD and DM was more pronounced in younger age groups and those with higher levels of inflammation. Therefore, early interventions for PD in younger patients may be crucial for preventing DM.
Summary
Korean summary
- 치주 질환과 당뇨병 사이의 연관성은 젊은 연령과 염증 수치가 높게 나타난 대상에서 더 두드러지게 나타남
- 치주 질환과 높은 염증 수치를 동시에 가지고 있을 경우의 당뇨 오즈비는 각각의 오즈비 합보다 더 크게 나타나 시너지 효과를 보였음
- 젊은 치주 질환 환자에 대한 조기 개입은 당뇨병 예방에 중요하게 작용할 수 있음
Key Message
• The association between PD and DM was more pronounced in younger age groups and those with higher levels of in- flammation.
• The odds of DM increased synergistically for those with both PD and high inflammatory status.
• Therefore, early interventions for PD in younger patients may be crucial for preventing DM.
Citations
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