Association between periodontitis and glycated hemoglobin levels in individuals living in rural Southern Brazil

Clin Oral Investig. 2021 Dec;25(12):6901-6907. doi: 10.1007/s00784-021-03980-y. Epub 2021 May 31.

Abstract

Objectives: To estimate the prevalence of prediabetes in individuals with moderate or severe periodontitis and to verify the association between periodontitis and glycated hemoglobin levels.

Material and methods: A cross-sectional study was conducted including individuals age 18-93 years from a representative sample residing in rural Southern Brazil. Data collection included full mouth periodontal clinical examinations, laboratory screens, and structured questionnaires. Glycemic levels were based on glycated hemoglobin. Periodontitis case definition was based on criteria established by the Centers for Disease Control and Prevention and the American Academy of Periodontology. A logistic regression model adjusted for body mass index was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The association between periodontal parameters and changes in glycated hemoglobin levels was evaluated using linear regression models.

Results: A higher prevalence of prediabetes was observed among individuals with moderate (39.6%) and severe periodontitis (49.7%) than in individuals with mild (23.8%) or no periodontitis (27.8%). Adjusting for body mass index, individuals with severe periodontitis exhibited a 2.5 greater chance of being prediabetic (OR=2.5; 95% CI: 1.3-4.9) that was significantly associated with an increase of 0.10% in HbA1c.

Conclusion: Severe periodontitis was associated with elevated blood glucose levels. Individuals with this condition having a higher percentage HbA1c are more likely to be prediabetic.

Clinical relevance: This study highlights the importance of the clinicians' awareness of the association between severe periodontitis and prediabetes allowing its early detection in the dental office.

Keywords: Cross-sectional study; Diabetes mellitus; Glycated hemoglobin; Periodontal disease.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2*
  • Glycated Hemoglobin / analysis
  • Humans
  • Middle Aged
  • Periodontitis* / epidemiology
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A