PLoS ONE (Jan 2022)

Association of type 2 diabetes with periodontitis and tooth loss in patients undergoing hemodialysis.

  • Risako Mikami,
  • Koji Mizutani,
  • Yusuke Matsuyama,
  • Tomohito Gohda,
  • Hiromichi Gotoh,
  • Norio Aoyama,
  • Takanori Matsuura,
  • Daisuke Kido,
  • Kohei Takeda,
  • Natsumi Saito,
  • Takeo Fujiwara,
  • Yuichi Izumi,
  • Takanori Iwata

DOI
https://doi.org/10.1371/journal.pone.0267494
Journal volume & issue
Vol. 17, no. 5
p. e0267494

Abstract

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BackgroundLimited evidence are available regarding the influence of diabetes on periodontitis in hemodialysis patients, although the association between diabetes and periodontal disease is well-known.ObjectiveThis study aimed to investigate the influence of type 2 diabetes mellitus (T2D) and its control level on periodontal disease and the number of missing teeth in patients undergoing hemodialysis.Subjects and methodsA single-center cross-sectional study was conducted on 246 Japanese patients with end-stage renal disease undergoing hemodialysis. Comprehensive medical and dental examinations were performed. The association between severity of periodontitis and T2D was examined by multiple ordered logistic regression analysis. A multiple linear regression model was fitted to assess the association of periodontal probing depth (PPD) ≥4 mm and the number of missing teeth with T2D (n = 125). A subgroup analysis involving only the patients with T2D was performed to investigate the factors associated with missing teeth among them.ResultsAfter adjusting for confounders, the classification of periodontitis severity was significantly advanced in patients with T2D (odds ratio: 1.64, 95% confidence interval [CI]: 1.02-2.65, p = 0.04). The proportion of PPD≥4 mm sites and the number of missing teeth was significantly associated with T2D (coefficient: 4.1 and 5.7, 95% CI: 0.2-8.0 and 3.4-8.0, p = 0.04 and ConclusionT2D was significantly associated with periodontitis and the number of missing teeth in hemodialysis patients. Moreover, it is first documented that poor glycemic control, as determined by glycoalbumin levels, was significantly associated with the number of missing teeth in hemodialysis patients with T2D.