TY - JOUR
T1 - Characterization of periodontitis in people with type 1 diabetes of 50 years or longer duration
AU - Shinjo, Takanori
AU - Ishikado, Atsushi
AU - Hasturk, Hatice
AU - Pober, David M.
AU - Paniagua, Samantha M.
AU - Shah, Hetal
AU - Wu, I. Hsien
AU - Tinsley, Liane J.
AU - Matsumoto, Motonobu
AU - Keenan, Hillary A.
AU - Van Dyke, Thomas E.
AU - Genco, Robert J.
AU - King, George L.
N1 - Funding Information:
This study would not have been possible without the staffs at the Joslin Clinical Research Center, Center for Clinical and Translational Research at The Forsyth Institute Dental Clinic, and the 50-Year Medalists and their families. This work was supported by National Institutes of Health/NIDDK P30DK036836, 1DP3DK094333-01, Juvenile Diabetes Research Foundation (17-2013-310), and a grant from Procter & Gamble (Cincinnati, OH) to Dr. Robert J. Genco. The Thomas J. Beatson, Jr. Foundation was also one of the supporters for this project. Dr. Takanori Shinjo was the recipient of a Research Fellowship (Hiroo Kaneda Scholarship, Sunstar Foundation, Japan). Drs. Atsushi Ishikado and Motonobu Matsumoto are employees of Sunstar. Dr. Hillary A. Keenan is an associate director of Biostatistics and Epidemiology at Sanofi Genzyme.
Publisher Copyright:
© 2019 American Academy of Periodontology
PY - 2019
Y1 - 2019
N2 - Background: Periodontitis is more common and severe in people with diabetes than the general population. We have reported in the Joslin Medalist Study that people with type 1 diabetes of ≥50 years (Medalists) may have endogenous protective factors against diabetic nephropathy and retinopathy. Methods: In this cross-sectional study, the prevalence of periodontitis according to the Centers for Disease Control/American Academy of Periodontology classification in a subset (n = 170, mean age = 64.6 ± 6.9 years) of the Medalist cohort, and its associations to various criteria of periodontitis and diabetic complications were assessed. Results: The prevalence of severe periodontitis in Medalists was only 13.5% which was lower than reported levels in diabetic patients of similar ages. Periodontal parameters, including bleeding on probing, plaque index, gingival index, and demographic traits, including male sex, chronological age, and age at diagnosis were significantly associated with severity of periodontitis, which did not associate with diabetes duration, hemoglobin A1c (HbA1c), body mass index, and lipid profiles. Random serum C-peptide levels inversely associated with severity of periodontitis (P = 0.03), lower probing depth (P = 0.0002), and clinical attachment loss (P = 0.03). Prevalence of cardiovascular diseases (CVD) and systemic inflammatory markers, plasma interleukin-6 (IL-6), and serum immunoglobulin G titer against Porphyromonas gingivalis positively associated with severity of periodontitis (P = 0.002 and 0.02, respectively). Antibody titer to P. gingivalis correlated positively and significantly with CVD, serum IL-6, and high-sensitivity C-reactive protein. Conclusions: Some Medalists could be protected from severe periodontitis even with hyperglycemia. Endogenous protective factors for periodontitis could possibly be related to residual insulin production and lower levels of chronic inflammation.
AB - Background: Periodontitis is more common and severe in people with diabetes than the general population. We have reported in the Joslin Medalist Study that people with type 1 diabetes of ≥50 years (Medalists) may have endogenous protective factors against diabetic nephropathy and retinopathy. Methods: In this cross-sectional study, the prevalence of periodontitis according to the Centers for Disease Control/American Academy of Periodontology classification in a subset (n = 170, mean age = 64.6 ± 6.9 years) of the Medalist cohort, and its associations to various criteria of periodontitis and diabetic complications were assessed. Results: The prevalence of severe periodontitis in Medalists was only 13.5% which was lower than reported levels in diabetic patients of similar ages. Periodontal parameters, including bleeding on probing, plaque index, gingival index, and demographic traits, including male sex, chronological age, and age at diagnosis were significantly associated with severity of periodontitis, which did not associate with diabetes duration, hemoglobin A1c (HbA1c), body mass index, and lipid profiles. Random serum C-peptide levels inversely associated with severity of periodontitis (P = 0.03), lower probing depth (P = 0.0002), and clinical attachment loss (P = 0.03). Prevalence of cardiovascular diseases (CVD) and systemic inflammatory markers, plasma interleukin-6 (IL-6), and serum immunoglobulin G titer against Porphyromonas gingivalis positively associated with severity of periodontitis (P = 0.002 and 0.02, respectively). Antibody titer to P. gingivalis correlated positively and significantly with CVD, serum IL-6, and high-sensitivity C-reactive protein. Conclusions: Some Medalists could be protected from severe periodontitis even with hyperglycemia. Endogenous protective factors for periodontitis could possibly be related to residual insulin production and lower levels of chronic inflammation.
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U2 - 10.1002/JPER.18-0735
DO - 10.1002/JPER.18-0735
M3 - Article
C2 - 31026349
AN - SCOPUS:85069233892
VL - 90
SP - 565
EP - 575
JO - Journal of Periodontology
JF - Journal of Periodontology
SN - 0022-3492
IS - 6
ER -