Association of Periodontal Parameters With Metabolic Level and Systemic Inflammatory Markers in Patients With Type 2 Diabetes

Backgrounds: Although worldwide evidence tends to prove that diabetes adversely affects periodontal health, there are insufficient clues indicating whether periodontitis may aggravate metabolic control and systemic inflammation. This study, as a preliminary part of an ongoing research project, aims to clarify the relationship of periodontal parameters with metabolic levels and systemic inflammatory markers in patients with diabetes. Methods: A total of 140 qualified, adult patients with type 2 diabetes and periodontitis were recruited into this study. Periodontal examinations, including a full-mouth assessment of probing depths (PDs), bleeding on probing, gingival recession, and clinical attachment level, were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting glucose, high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-alpha), and lipid profiles. Subjects were divided into three groups according to tertiles of the mean PD and compared. Results: Upon an analysis of covariance, subjects with an increased mean PD had significantly higher levels of HbA1c and hsCRP (P <0.05). No significant difference was found among different groups in the levels of serum TNF-alpha, fasting glucose, and lipid profiles (P >0.05). After controlling for age, gender, body mass index, duration of diabetes mellitus, smoking, regular physical exercise, and alcohol consumption, positive correlations were found between mean PD and HbA1c (r = 0.2272; P= 0.009) and between mean PD and hsCRP (r = 0.2336; P= 0.007). After adjustment for possible confounders, the mean PD emerged as a significant predictor variable for elevated levels of HbA1c and hsCRP (P<0.05). Conclusion: Chronic periodontitis was associated with glycemic metabolic and serum hsCRP levels in patients with type 2 diabetes. J Periodontol 2010;81:364-371.