Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus
: Blackwell Synergy
Aim: The aim of this study was to investigate the relationship between markers of
metabolic control and inflammation and periodontal disease parameters in patients
Material & Methods: One hundred and eighty one adult patients with diabetes
attending treatment at two diabetes centres were invited to participate in the study.
Periodontal examination included full-mouth assessment for probing depths and
bleeding on probing (BOP). Blood analyses were carried out for glycated
haemoglobin, (HbA1c), high-sensitivity C reactive protein, (hsCRP) and lipid
profile comprising total cholesterol, low-density lipoprotein cholesterol (LDL chol),
high-density lipoprotein cholesterol (HDL chol) and triglycerides.
Results: Upon multivariate analysis, periodontal disease severity in terms of increased
percentage of BOP and mean percentage of sites with probing depthsX5mm were found
to be associated with inadequate glycaemic control as measured by HbA1c ( po0.01).
HsCRP was also found to be a significant predictor for mean percentage of sites with
probing depths X5mm ( po0.05). After controlling for age, gender, smoking habits and
number of teeth, positive correlations were found between HbA1c and percentage sites
with probing depths X5mm, percentage sites BOP, total cholesterol, LDL chol and
triglycerides ( po0.05). Using the adjusted differences, subjects with acceptable glycaemic
control (HbA1c o8%) showed a lower percentage of sites with BOP and probing depths
X5mm(po0.05) when compared with those having inadequate glycaemic control. There
was also a trend towards lower blood cholesterol in the well-controlled group.
Conclusion: The level of glycaemic control as measured by HbA1c emerged as the
most consistent risk factor associated with the extent and severity of periodontal
disease in this study cohort.
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