HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager patientINFORMation Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Saremi, A. Articles by Knowler, W. C. Search for Related Content PubMed PubMed Citation Articles by Saremi, A. Articles by Knowler, W. C. Social Bookmarking                What's this?

Periodontal Disease and Mortality in Type 2 Diabetes

¹ National Institute of Diabetes and Digestive and Kidney Disease, Phoenix, Arizona
² University of Michigan School of Dentistry, Ann Arbor, Michigan
³ University at Buffalo, Buffalo, New York

Address correspondence to Robert G. Nelson, MD, PhD, 1550 E. Indian School Rd., Phoenix, AZ 85014. E-mail: rgnelson{at}mail.nih.gov

OBJECTIVE—Periodontal disease may contribute to the increased mortality associated with diabetes.

RESEARCH DESIGN AND METHODS—In a prospective longitudinal study of 628 subjects aged 35 years, we examined the effect of periodontal disease on overall and cardiovascular disease mortality in Pima Indians with type 2 diabetes. Periodontal abnormality was classified as no or mild, moderate, and severe, based on panoramic radiographs and clinical dental examinations.

RESULTS—During a median follow-up of 11 years (range 0.3–16), 204 subjects died. The age- and sex-adjusted death rates for all natural causes expressed as the number of deaths per 1,000 person-years of follow-up were 3.7 (95% CI 0.7–6.6) for no or mild periodontal disease, 19.6 (10.7–28.5) for moderate periodontal disease, and 28.4 (22.3–34.6) for severe periodontal disease. Periodontal disease predicted deaths from ischemic heart disease (IHD) (P trend = 0.04) and diabetic nephropathy (P trend < 0.01). Death rates from other causes were not associated with periodontal disease. After adjustment for age, sex, duration of diabetes, HbA_1c, macroalbuminuria, BMI, serum cholesterol concentration, hypertension, electrocardiographic abnormalities, and current smoking in a proportional hazards model, subjects with severe periodontal disease had 3.2 times the risk (95% CI 1.1–9.3) of cardiorenal mortality (IHD and diabetic nephropathy combined) compared with the reference group (no or mild periodontal disease and moderate periodontal disease combined).

CONCLUSIONS— Periodontal disease is a strong predictor of mortality from IHD and diabetic nephropathy in Pima Indians with type 2 diabetes. The effect of periodontal disease is in addition to the effects of traditional risk factors for these diseases.

Abbreviations: CVD, cardiovascular disease • ECG, electrocardiogram • IHD, ischemic heart disease • PAF, population attributable fraction

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

Find additional patient-related information at:

Gum Disease and Type 2 Diabetes

This article has been cited by other articles:

				I. B. Lamster, E. Lalla, W. S. Borgnakke, and G. W. Taylor The Relationship Between Oral Health and Diabetes Mellitus J Am Dent Assoc, October 1, 2008; 139(suppl_5): 19S - 24S. [Abstract] [Full Text] [PDF]

				C.W. Bassim, R.S. Redman, D.J. DeNucci, K.L. Becker, and E.S. Nylen Salivary Procalcitonin and Periodontitis in Diabetes J. Dent. Res., July 1, 2008; 87(7): 630 - 634. [Abstract] [Full Text] [PDF]

				H. Iwata, Y. Soga, M. Meguro, S. Yoshizawa, Y. Okada, Y. Iwamoto, A. Yamashita, S. Takashiba, and F. Nishimura High glucose up-regulates lipopolysaccharide-stimulated inflammatory cytokine production via c-jun N-terminal kinase in the monocytic cell line THP-1 Innate Immunity, August 1, 2007; 13(4): 227 - 234. [Abstract] [PDF]

				W. A. Shultis, E. J. Weil, H. C. Looker, J. M. Curtis, M. Shlossman, R. J. Genco, W. C. Knowler, and R. G. Nelson Effect of Periodontitis on Overt Nephropathy and End-Stage Renal Disease in Type 2 Diabetes Diabetes Care, February 1, 2007; 30(2): 306 - 311. [Abstract] [Full Text] [PDF]

				B. Goldfarb Periodontal Disease Linked to Mortality in Type 2 Diabetes DOC News, June 1, 2005; 2(6): 9 - 9. [Full Text]

				B. L. PIHLSTROM and L. TABAK The National Institute of Dental and Craniofacial Research: Research for the practicing dentist J Am Dent Assoc, June 1, 2005; 136(6): 728 - 737. [Abstract] [Full Text] [PDF]