Albuminuria, C-reactive protein, and socioeconomic factors are associated with periodontal status in subjects with type 2 diabetes
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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.
KeywordsPeriodontitis Type 2 diabetes Albuminuria C-reactive protein Education Dental attendance
National Health and Nutrition Examination Survey
Glycated hemoglobin A1c
Low density lipoprotein
High density lipoprotein
Probing pocket depth
Japan Diabetes Society
Bleeding on probing
Body mass index
Urinary albumin-to-creatinine ratio
Glomerular filtration rate
Coronary heart disease
Ms. Miki Satoh and Mr. Suguho Takahashi (Jiyugaoka Medical Clinic, Obihiro, Japan) are thanked for their skillful data collection and managing research office.
No particular fund.
Compliance with ethical standards
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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