Periodontitis and retinal blood vessel changes in diabetes

Summarised from:

Periodontitis and retinal microcirculation in the Atherosclerosis Risk in Communities study
(Journal of Clinical Periodontology; doi: 10.1111/jcpe.12388)

Authors:

Adrien Boillot, Philippe Bouchard, Kevin Moss, Steven Offenbacher, Sébastien Czernichow

Summarised by:

Dr Varkha Rattu

Research Topic:

Background + Aims

Retinal photographs allow researchers to examine small blood vessels non-invasively. Changes in these vessels may help investigate links between periodontal inflammation, diabetes and vascular health.
This study aimed to:
- Examine whether periodontitis was associated with altered retinal vessel diameter and explore differences according to diabetes status.

Materials + Methods

This cross-sectional analysis included 457 Atherosclerosis Risk in Communities (ARIC) participants, including 66 with diabetes.
Periodontitis was classified using CDC/AAP criteria.
Retinal photographs measured central retinal arteriolar/venular equivalents (CRAE and CRVE) – arteriolar and venular diameters
Models adjusted for demographic, socioeconomic and cardiovascular risk factors using propensity scores.
- A propensity score combines measured characteristics into a statistical adjustment – it cannot eliminate unmeasured confounding.

Results

Adjusted mean venular diameter was 187.0 μm in the healthy/gingivitis group, 188.5 μm with moderate periodontitis and 191.6 μm with severe periodontitis.
- Only the severe-periodontitis comparison was significant (p = .04).
Severe periodontitis was associated with higher odds of being in the widest venular-diameter quartile: OR 2.18; 95% CI 1.15–4.13.
The venular association remained significant in the diabetes subgroup (p = .01).
No consistent association was found with arteriolar diameter.

Limitations

Cross-sectional findings cannot establish causation or which condition came first.
The diabetes subgroup was small.
Exclusions and missing data may have introduced selection bias.
Inflammatory-marker data were insufficient to test the proposed mechanism.
A significant result in one subgroup and a non-significant result in another do not, by themselves, prove that diabetes modifies the association. Wider venules also should not be equated with a diagnosis of diabetic retinopathy.

Conclusion

The findings suggest a link between severe periodontitis and retinal microvascular changes, particularly in diabetes. They do not establish that periodontitis causes diabetic eye disease or that periodontal treatment prevents vascular complications.

Read the full article Back to Research

Research | 07.04.15

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