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Albuminuria, C-reactive protein, and socioeconomic factors are associated with periodontal status in subjects with type 2 diabetes

  • Hiroki Yokoyama
  • Tatsuo Yamamoto
  • Michio Tanaka
  • Chieko Kudo
  • Koichi Hidaka
  • Nobuichi Kuribayashi
  • Masato Minabe
Original Article
  • 74 Downloads

Abstract

Diabetes and periodontitis may increase risk of cardiovascular disease. Whether albuminuria, C-reactive protein (CRP), and socioeconomic factors, known as cardiovascular risks in subjects with poorly controlled diabetes, are independently associated with periodontal status in well-controlled diabetes remains to be elucidated. In 503 subjects with type 2 diabetes, the cross-sectional associations of clinical and socioeconomic factors with periodontal parameters were investigated. Periodontal parameters on all teeth included the probing pocket depth at 6 sites per tooth, bleeding on probing, the plaque score, tooth mobility, and the number of teeth. The subjects had a mean HbA1c value of 6.85% and a median CRP value of 0.06 mg/dL, and 27.9% of the subjects had albuminuria. Albuminuria and CRP values had significant associations with several periodontal parameters, whereas other variables including HbA1c did not. Subjects with albuminuria had significantly higher HbA1c, CRP, and % sites of pocket depth ≥ 4 mm than subjects with normoalbuminuria; additionally, those with high CRP (≥ median) had significantly higher body mass index, HbA1c, % sites of pocket depth ≥ 4 mm, and plaque score than those with low CRP. In multiple linear regression analysis, albuminuria, CRP, education, smoking, and dental attendance exhibited significant associations with periodontal parameters, independent of the effect of age, sex, body mass index, and diabetes therapy. Albuminuria, CRP, education, smoking, and dental attendance were independently associated with periodontal parameters even in subjects with a mean of HbA1c of 6.85%, implying the importance of these factors for the prevention of cardiovascular disease.

Keywords

Periodontitis Type 2 diabetes Albuminuria C-reactive protein Education Dental attendance 

Abbreviations

CVD

Cardiovascular disease

CRP

C-reactive protein

BP

Blood pressure

NHANES

National Health and Nutrition Examination Survey

HbA1c

Glycated hemoglobin A1c

LDL

Low density lipoprotein

HDL

High density lipoprotein

PPD

Probing pocket depth

JDS

Japan Diabetes Society

BOP

Bleeding on probing

BMI

Body mass index

Cr

Creatinine

ACR

Urinary albumin-to-creatinine ratio

GFR

Glomerular filtration rate

CHD

Coronary heart disease

Notes

Acknowledgements

Ms. Miki Satoh and Mr. Suguho Takahashi (Jiyugaoka Medical Clinic, Obihiro, Japan) are thanked for their skillful data collection and managing research office.

Funding

No particular fund.

Compliance with ethical standards

Ethical approval

The study protocol was approved on Oct. 27th in 2014 by the Jiyugaoka Medical Clinic Ethical Board number #250716. All participants provided written informed consent and the study was carried out in accordance with the Helsinki Declaration II.

Conflict of interest

All authors have no conflicts of interest to disclose.

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Copyright information

© The Japan Diabetes Society 2018

Authors and Affiliations

  • Hiroki Yokoyama
    • 1
  • Tatsuo Yamamoto
    • 2
  • Michio Tanaka
    • 2
  • Chieko Kudo
    • 3
  • Koichi Hidaka
    • 3
  • Nobuichi Kuribayashi
    • 4
  • Masato Minabe
    • 3
  1. 1.Jiyugaoka Medical ClinicInternal MedicineObihiroJapan
  2. 2.Division of Dental Sociology, Department of Oral Science, Graduate School of DentistryKanagawa Dental UniversityYokosukaJapan
  3. 3.Division of Periodontology, Department of Interdisciplinary Medicine, Graduate School of DentistryKanagawa Dental UniversityYokosukaJapan
  4. 4.Misaki Naika ClinicFunabashiJapan

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