Periodontal infection, impaired fasting glucose and impaired glucose tolerance: results from the Continuous National Health and Nutrition Examination Survey 2009-2010

J Clin Periodontol. 2014 Jul;41(7):643-52. doi: 10.1111/jcpe.12258. Epub 2014 May 25.

Abstract

Aim: We investigated the relationship between periodontal disease, a clinical manifestation of periodontal infection, and pre-diabetes.

Methods: The National Health and Nutrition Examination Survey, 2009-2010 enrolled 1165 diabetes-free adults (51% female) aged 30-80 years (mean ± SD=50 ± 14) who received a full-mouth periodontal examination and an oral glucose tolerance test. Participants were classified as having none/mild, moderate or severe periodontitis and also according to mean probing depth ≥ 2.19 mm or attachment loss ≥ 1.78 mm, (respective 75th percentiles). Pre-diabetes was defined according to ADA criteria as either: (i) impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). In multivariable logistic regression models, the odds of IFG and IGT were regressed on levels of periodontitis category.

Results: The odds ratios and 95% confidence intervals for having IGT among participants with moderate or severe periodontitis, relative to participants with none/mild periodontitis were 1.07 [0.50, 2.25] and 1.93 [1.18, 3.17], p = 0.02. The ORs for having IFG were 1.14 [0.74, 1.77] and 1.12 [0.58, 2.18], p = 0.84. PD ≥ 75 th percentile was related to a 105% increase in the odds of IGT: OR [95% CI] = 2.05 [1.24, 3.39], p = 0.005.

Conclusions: Periodontal infection was positively associated with prevalent impaired glucose tolerance in a cross-sectional study among a nationally representative sample.

Keywords: glucose metabolism; infection; periodontal disease; periodontitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cross-Sectional Studies
  • Fasting
  • Female
  • Glucose Intolerance / epidemiology*
  • Glucose Tolerance Test
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Periodontal Attachment Loss / epidemiology
  • Periodontal Diseases / epidemiology*
  • Periodontal Pocket / epidemiology
  • Periodontitis / epidemiology
  • Prediabetic State / epidemiology
  • Risk Assessment
  • Sex Factors
  • United States / epidemiology

Substances

  • Blood Glucose
  • C-Reactive Protein