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Association between periodontitis and glycosylated haemoglobin before diabetes onset: a cross-sectional study

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Abstract

Objectives

The aim of the present cross-sectional study was to investigate the association between serum glycosylated haemoglobin (HbA1c) levels and periodontal status in patients with periodontitis (CP) and periodontally healthy controls. Furthermore, the objectives were to determine if the periodontitis influenced the serum HbA1c levels.

Materials and methods

A total of 93 patients with CP and 95 periodontally healthy subjects were enrolled in the present study using a cross-sectional design. At baseline, patients were examined and characterized on a regular basis for blood serum parameters and non-fasting blood samples levels. In all patients, a full periodontal examination was performed and clinical attachment loss (CAL) was the primary outcome variable chosen. The spearman correlation, a stepwise multivariable linear regression, and Jonckheere-Terpstra tests were applied in order to assess the relationship between HbA1c levels and periodontitis.

Results

Patients in the CP group presented a significantly higher median serum level of HbA1c [40.9 (31.2; 45.6) mmol/mol)] compared to patients in the healthy control group [35.3 (29.6; 38.6) mmol/mol)] (p < 0.001). HbA1c levels were negatively correlated with the number of teeth and positively correlated with C-reactive protein levels and all periodontal parameters (p < 0.001). Moreover, there was a significant decrease in the number of teeth when HbA1c levels increased (P-trend < 0.001), while there was a significant increase in periodontal parameters (CAL, p = 0.002); PD, p = 0.008; BOP, p < 0.001) when levels of HbA1c increased.

Conclusions

Patients with CP and undiagnosed diabetes presented significantly higher serum levels of HbA1c compared to periodontally healthy controls. Moreover, the presence of periodontitis was positively correlated with serum HbA1c levels before diabetes onset.

Clinical relevance

HbA1c levels were positively correlated with the severity of periodontitis before diabetes onset.

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Acknowledgments

All authors were involved in drafting the manuscript and took responsibility for the integrity of the data that are presented in this study.

Funding

This work was carried out with funding by the Department of University of Catania.

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Authors and Affiliations

  1. Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia n° 78, 95125, Catania, Italy

    Gaetano Isola, Eugenio Pedullà & Ernesto Rapisarda

  2. Department of Biomedical, Odontostomatological, Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy

    Giovanni Matarese

  3. Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy

    Luca Ramaglia & Vincenzo Iorio-Siciliano

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  1. Gaetano Isola
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Contributions

G.I. conceived the idea and wrote the paper. G.I., G.M, L.R., E.P. and E.R. reviewed the collected data. G.I. and V.I.S. were responsible for editing, original data and text preparation. All authors took responsibility for the integrity of the data that is present in this study.

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Correspondence to Gaetano Isola.

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The authors declare that they have no conflicts of interest.

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This study followed the Declaration of Helsinki on medical protocol, and the institutional review board of the University of Messina, Messina, Italy, approved the study protocol (12/16). Written informed consent was obtained from the patient for publication. A copy of the written consent may be requested for review from the corresponding author.

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Isola, G., Matarese, G., Ramaglia, L. et al. Association between periodontitis and glycosylated haemoglobin before diabetes onset: a cross-sectional study. Clin Oral Invest 24, 2799–2808 (2020). https://doi.org/10.1007/s00784-019-03143-0

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