Table 1.
Clinical evidence of periodontitis as a promoting factor of T2D
| Design | Sample size and characteristics | Exposure | Main outcomes |
|---|---|---|---|
| Cross-sectional study11 | 37 patients with severe periodontitis and 37 patients with healthy periodontium. |
•PPD •CAL |
FBG (P < 0.001), HbA1c (P < 0.05), HOMA-IR (P < 0.05), and IFG (OR:7.489, 95% CI: 1.408–39.839; P < 0.01) were increased in patients with severe periodontitis. |
| Cross-sectional study12 | 5070 patients with periodontitis and 12,108 patients without periodontitis | •CPI score | IFG (P < 0.001) was increased and HOMA-β (P < 0.001) was decreased in periodontitis patients. |
| Cross-sectional study13 | 665 patients with no/mild periodontitis and 500 patients with moderate/severe periodontitis |
•PPD •CAL |
IGT was increased in patients with moderate (OR:1.07, 95% CI: 0.50-2.25; P = 0.02) or severe (OR:1.93, 95% CI:1.18–3.17; P = 0.02) periodontitis. |
| Cross-sectional study14 | 47 patients with periodontitis and 63 patients without periodontitis among severely obese, nondiabetic individuals |
•PPD •BOP •CAL |
The serum GLP-1 level (P < 0.000 1) was decreased in periodontitis patients. |
|
Prospective cohort study, Follow-up:5 years15 |
1341 patients with periodontitis and 4033 patients without periodontitis | •CPI score | Incidence of hyperglycemia was increased by 33% (aHR:1.33, 95% CI :1.09–1.63) in periodontitis patients. |
| Retrospective cohort study, Mean follow-up: 5.47 ± 3.54 years16 | 22299 patients with periodontitis needing dental surgery and 22302 patients with periodontitis not requiring dental surgery |
•Subgingival curettage •Periodontal flap procedure |
Incidence of T2D was 1.24-fold higher (aHR:1.19,95% CI :1.10–1.29) in patients with periodontitis needing dental surgery. |
| Cross sectional study17 | 207 patients with periodontitis and 67 patients without periodontitis in T2D patients |
•PPD •CAL •LGM •PI •GI |
FBG (P < 0.000 1), HbA1c (P < 0.000 1) and the risk of diabetes-associated complications (P < 0.000 1) were increased in T2D patients with periodontitis patients. |
| Cross sectional study18 | 20 T2D patients with periodontitis, 20 T2D patients without periodontitis and 20 nondiabetic controls with periodontitis |
•BOP •PPD |
HbA1c (P = 0.002) and FBG (P = 0.04) were increased and HOMA-β (P = 0.01) was decreased in T2D with periodontitis patients. |
| Cross sectional study19 | 50 patients with chronic periodontitis and 50 patients without periodontitis. |
•PI •OHI-s •MGI •PPD •CAL |
HbA1c (P = 0.001) and FBG (P = 0.002) were increased in chronic periodontitis patients. |
| Cross sectional study24 | 126 patients with none/mild periodontitis, 156 patients with moderate periodontitis and 18 patients with severe periodontitis | •Bacterial burden score | Higher colonization levels of specific periodontal microbiota are associated with higher prediabetes prevalence among diabetes-free adults (A. actinomycetemcomitans, 2.48 (1.34, 4.58), P = 0.004; P. gingivalis, 3.41 (1.78, 6.58), P = 0.000 3; T. denticola, 1.99 (0.992, 4.00), P = 0.052). |
| Cross sectional study25 | 114 patients with none/mild periodontitis, 159 patients with moderate periodontitis and 27 patients with severe periodontitis. | •The relative abundance of bacterial phyla | The levels of Actinobacteria, Proteobacteria or Firmicutes were associated with insulin resistance (P < 0.05), and the strongest positive correlations between bacterial taxa and HOMA-IR was for Prevotella sp. HOT-299_AH07, r = 0.21 (P = 0.01). |
| Cross sectional study26 | 52 non-alcoholic fatty liver disease | •IgG antibody titers | Anti-A. actinomycetemcomitans IgG antibody titer correlated positively with the HOMA-IR (P = 0.001, ρ = 0.46). |
| Cross sectional study7 | 97 patients with none/mild periodontitis, 117 patients with moderate periodontitis and 16 patients with severe periodontitis. | •Microbial dysbiosis index | Higher levels of the microbial dysbiosis index were strongly associated with higher levels of glucose change after multivariable adjustment (P < 0.000 1). Baseline levels of 9 taxa predicted FBG change (all FDR < 0.05), among which Stomatobaculum sp oral taxon 097 and Atopobium spp predicted greater FBG change. |
T2D type 2 diabetes, PPD probing pocket depth, CAL clinical attachment level, FBG fasting blood glucose, IFG impaired fasting glucose, OR odds ratio, CI confidence intervals, aHR adjusted hazard ratio, HbA1c glycated hemoglobin, HOMA-IR homeostasis model assessments of IR, CPI community periodontal index, HOMA-β homeostasis model assessments of β-cell function, IGT impaired glucose tolerance, BOP bleeding on probing, GLP-1 glucagon-like peptide-1, LGM location of gingival margin, PI plaque index, GI gingival index, OHI-s simplified oral hygiene index, MGI modified gingival index, FDR false discovery rate