Impact of periodontitis on diabetic complications

Background + Aims

• Cardiovascular health and periodontal health share several determinants, including smoking and blood glucose regulation. Assessing these determinants together may help clarify how overall health relates to periodontal disease.
• This study aimed to:
  • Investigate whether cardiovascular health, measured using the American Heart Association’s Life’s Essential 8 (LE8) score, was associated with periodontitis.

Materials + Methods

• Cross-sectional analysis of 9,296 adults aged ≥30 years from NHANES 2009–2014.
• Periodontitis was identified using clinical attachment loss and probing-depth measurements.
• LE8 combines:
  • 4 health behaviours – diet, physical activity, nicotine exposure and sleep
  • 4 health factors – body mass index, blood cholesterol, blood glucose and blood pressure.
• Each component is scored from 0–100; their average produces the overall score.
• Cardiovascular health was classified as low (0–49), moderate (50–79) or high (80–100).
• Survey-weighted regression adjusted for demographic and socioeconomic characteristics, including age, education, poverty index and health insurance.

Results

• The weighted prevalence of periodontitis was 42.0%.
• Compared with low cardiovascular health, moderate and high cardiovascular health were associated with lower odds of periodontitis
  • OR 0.62 (95% CI 0.52–0.74) for association between moderate cardiovascular health and periodontitis
  • OR 0.43 (95% CI 0.33–0.57) for association between high cardiovascular health and periodontitis
• Each 10-point higher LE8 score was associated with 18% lower odds of periodontitis: OR 0.82 (95% CI 0.78–0.86).
  • This describes differences between participants, not the effect of improving an individual’s score.
• Associations were stronger for the health-behaviour score.
  • Moderate and high health-factor categories were not significantly associated with periodontitis, although the continuous health-factor score showed a small association.
• Individually, reduced nicotine-exposure, improved physical-activity and blood-glucose scores were associated with lower odds of periodontitis.
• Higher overall scores were also associated with less severe periodontitis, shallower probing depths and lower clinical attachment loss.

Limitations