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Diabetes Care. 2019 Jun 10. pii: dc190018. doi: 10.2337/dc19-0018. [Epub ahead of print]

Undetected Dysglycemia an Important Risk Factor for Two Common Diseases Myocardial Infarction and Periodontitis: A Report From the PAROKRANK Study.

Author information

1
Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden anna.norhammar@ki.se.
2
Capio St. Görans hospital, Stockholm, Sweden.
3
Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden.
4
Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
5
Faculty of Odontology, Department of Periodontology, Malmö University, Malmö, Sweden.
6
Department of Clinical Sciences Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.
7
Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden.

Abstract

OBJECTIVE:

Information on the relationship among dysglycemia (prediabetes or diabetes), myocardial infarction (MI), and periodontitis (PD) is limited. This study tests the hypothesis that undetected dysglycemia is associated with both conditions.

RESEARCH DESIGN AND METHODS:

The PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study included 805 patients with a first MI and 805 matched control subjects. All participants without diabetes (91%) were examined with an oral glucose tolerance test. Abnormal glucose tolerance ([AGT] = impaired glucose tolerance or diabetes) was categorized according to the World Health Organization). Periodontal status was categorized from dental X-rays as healthy (≥80% remaining alveolar bone height), moderate (79-66%), or severe (<66%) PD. Odds ratios (ORs) and 95% CIs were calculated by logistic regression, and were adjusted for age, sex, smoking, education, marital status, and explored associated risks of dysglycemia to PD and MI, respectively.

RESULTS:

AGT was more common in patients than in control subjects (32% vs. 19%; P < 0.001) and was associated with MI (OR 2.03; 95% CI 1.58-2.60). Undetected diabetes was associated with severe PD (2.50; 1.36-4.63) and more strongly in patients (2.35; 1.15-4.80) than in control subjects (1.80; 0.48-6.78), but not when categorized as AGT (total cohort: 1.07; 0.67-1.72). Severe PD was most frequent in subjects with undetected diabetes, and reversely undetected diabetes most frequent in patients with severe PD.

CONCLUSIONS:

In this large case-control study previously undetected dysglycemia was independently associated to both MI and severe PD. In principal, it doubled the risk of a first MI and of severe PD. This supports the hypothesis that dysglycemia drives two common diseases, MI and PD.

PMID:
31182493
DOI:
10.2337/dc19-0018

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