IADR Abstract Archives
Periodontal Infections and Type 2 Diabetes Risk: The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS)
Objectives: Periodontal infections have been hypothesized as a cardiometabolic risk factor. The relationship between periodontal microbiota and early diabetes risk has not been studied. We investigated the association between periodontal infections and both prevalent prediabetes and longitudinal plasma glucose progression among diabetes-free adults.
Methods: The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) enrolled 300 diabetes-free adults (77% female) aged 20-55 years (mean=34±10). Fasting plasma glucose (FPG) and HbA1c were assessed from blood after overnight fasting. Prevalent prediabetes was defined as: i) 5.7%≤HbA1C≤6.4%; or ii) 100 mg/dL≤FPG≤125 mg/dL. Full-mouth clinical periodontal exams were performed and severe/moderate periodontitis was defined via the CDC/AAP definition. In 1,188 subgingival plaques, 11 bacterial species including Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf) and Actinomyces naeslundii (An) were assessed using the DNA-DNA checkerboard method. Modified Poisson regression evaluated prediabetes prevalence across bacterial tertiles. Risk ratios (RR), 95% confidence intervals (CI) for 3rd vs. 1st tertile are presented. Longitudinal FPG was available for interim analysis among the first 100 recall-eligible participants (mean follow-up=2±0.3 years). Mixed-effects regressions evaluated FPG time trends across baseline periodontal status. All analyses were adjusted for cardiometabolic risk factors.
Results: RRs(95%CI) summarizing associations between bacteria and prediabetes follow: Aa=2.48[1.34,4.58], p=0.004; Pg=3.41[1.78,6.58], p=0.0003; Td=1.99[0.992,4.00], p=0.052; Tf=1.95[1.0,3.84], p=0.05; An=0.46[0.25,0.85], p=0.01. The RR for prediabetes among participants with moderate/severe vs. no/mild periodontitis was 1.47[0.78,2.74], p=0.23. Among participants with high baseline values of Pg or Tf, FPG increased by ~2.5 mg/dl during follow-up (all p-values〈0.05) while no FPG progression was observed among participants with low baseline bacterial levels. Periodontitis was not associated with FPG progression.
Conclusions: Specific periodontal microbiota, but not periodontitis, are associated with both prevalent prediabetes and longitudinal plasma glucose increase among young diabetes-free adults.
Methods: The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) enrolled 300 diabetes-free adults (77% female) aged 20-55 years (mean=34±10). Fasting plasma glucose (FPG) and HbA1c were assessed from blood after overnight fasting. Prevalent prediabetes was defined as: i) 5.7%≤HbA1C≤6.4%; or ii) 100 mg/dL≤FPG≤125 mg/dL. Full-mouth clinical periodontal exams were performed and severe/moderate periodontitis was defined via the CDC/AAP definition. In 1,188 subgingival plaques, 11 bacterial species including Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf) and Actinomyces naeslundii (An) were assessed using the DNA-DNA checkerboard method. Modified Poisson regression evaluated prediabetes prevalence across bacterial tertiles. Risk ratios (RR), 95% confidence intervals (CI) for 3rd vs. 1st tertile are presented. Longitudinal FPG was available for interim analysis among the first 100 recall-eligible participants (mean follow-up=2±0.3 years). Mixed-effects regressions evaluated FPG time trends across baseline periodontal status. All analyses were adjusted for cardiometabolic risk factors.
Results: RRs(95%CI) summarizing associations between bacteria and prediabetes follow: Aa=2.48[1.34,4.58], p=0.004; Pg=3.41[1.78,6.58], p=0.0003; Td=1.99[0.992,4.00], p=0.052; Tf=1.95[1.0,3.84], p=0.05; An=0.46[0.25,0.85], p=0.01. The RR for prediabetes among participants with moderate/severe vs. no/mild periodontitis was 1.47[0.78,2.74], p=0.23. Among participants with high baseline values of Pg or Tf, FPG increased by ~2.5 mg/dl during follow-up (all p-values〈0.05) while no FPG progression was observed among participants with low baseline bacterial levels. Periodontitis was not associated with FPG progression.
Conclusions: Specific periodontal microbiota, but not periodontitis, are associated with both prevalent prediabetes and longitudinal plasma glucose increase among young diabetes-free adults.