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Diabetes Care. 2010 May;33(5):1037-43. doi: 10.2337/dc09-1778. Epub 2010 Feb 25.

Periodontal status and A1C change: longitudinal results from the study of health in Pomerania (SHIP).

Author information

1
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.

Abstract

OBJECTIVE:

Infection may be a type 2 diabetes risk factor. Periodontal disease is a chronic infection. We hypothesized that periodontal disease was related to A1C progression in diabetes-free participants.

RESEARCH DESIGN AND METHODS:

The Study of Health in Pomerania (SHIP) is a population-based cohort in Germany including 2,973 diabetes-free participants (53% women; aged 20-81 years). Participants were categorized into four groups according to increasing baseline periodontal disease levels (percentage of sites per mouth with attachment loss >or=5 mm, determined a priori); sample sizes for each respective category were 1,122, 488, 463, and 479 (241 participants were edentulous). Mean absolute changes (year 5 minus baseline) in A1C (DeltaA1C) were regressed across periodontal categories while adjusting for confounders (e.g., age, sex, smoking, obesity, physical activity, and family history).

RESULTS:

Across baseline periodontal disease categories, DeltaA1C +/- SEM values were 0.023 +/- 0.02, 0.023 +/- 0.02, 0.065 +/- 0.03, and 0.106 +/- 0.03 (P(trend) = 0.02), yielding an approximate fivefold increase in the absolute difference in DeltaA1C when dentate participants in the highest versus lowest periodontal disease category were compared; these results were markedly stronger among participants with high-sensitivity C-reactive protein >or=1.0 mg/l (P(interaction) = 0.01). When individuals who had neither baseline periodontal disease nor deterioration in periodontal status at 5 years were compared with individuals with both poor baseline periodontal health and longitudinal periodontal deterioration, mean DeltaA1C values were 0.005 vs. 0.143% (P = 0.003).

CONCLUSIONS:

Periodontal disease was associated with 5-year A1C progression, which was similar to that observed for a 2-SD increase in either waist-to-hip ratio or age in this population.

PMID:
20185742
PMCID:
PMC2858171
DOI:
10.2337/dc09-1778
[Indexed for MEDLINE]
Free PMC Article

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