"Periodontal Disease and Incidence of Type 2 Diabetes Mellitus"
Abstract Number: 889-P
Authors: KAUMUDI J. JOSHIPURA, TRICIA Y. LI, CYNTHIA PEREZ, FRANK HU, San Juan, Puerto Rico, Boston, MA
Institutions: Boston, MA
Results: Chronic inflammation caused by periodontal disease has been associated with various systemic conditions including type 2 diabetes. A few published longitudinal studies show a relation between periodontitis and poor glycemic control among diabetics. To our knowledge, this is the first prospective study to assess whether periodontal disease and tooth loss are related to risk of type 2 diabetes. This study utilized data from two prospective cohort studies, including 39,964 men aged 40-75 years in the Health Professionals’ Follow-up Study followed for 18 years (1986-2004) and 67,394 women aged 34-59 years from the Nurses’ Health Study followed for 12 years (1992-2004). Self-reported periodontal disease was assessed by validated mailed questionnaires. Participants free of type 2 diabetes at baseline were followed for subsequent reports of newly diagnosed type 2 diabetes; the reports were subsequently verified from medical records. We used Cox proportional hazards models with time-dependent variables, updated using the biennial questionnaires, to compute rate ratios relating periodontal disease to incidence of type 2 diabetes. We adjusted for age, gender, smoking, family history of diabetes, number of teeth, exercise, obesity, alcohol, family history of diabetes, profession, and diet (refined carbohydrates, sugar, fiber). The multivariate relative risk for periodontitis (comparing moderate/severe versus none/mild) was 1.25 in men (95% CI: 0.84-1.87) and 1.78 (95% CI: 1.08-2.94) in women. When a binary measure of periodontitis was updated using biennial questionnaires the RR was 1.38 (95% CI: 1.17-1.61) in men; similar updated data was not available in women. The multivariate RR for tooth loss (≥3 vs. 0 teeth lost during follow-up) was 1.57 (95% CI: 1.04-2.36) in men and 1.29 (95% CI: 0.82-2.04) in women. Our results suggest that periodontal disease and fewer teeth may be related with increased risk of type 2 diabetes.