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Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35–44 years (KCIS No. 32)

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Abstract

The relationship between hyperglycemia (including diabetes) and periodontal disease (PD) has been noted previously, but its temporal sequence in the same study based on a population-based study has been barely addressed. Our study sought to clarify temporal bidirectional relationships between both diseases among Taiwanese aged 35–44 years. A prospective follow-up cohort study was designed by following over time the two normal cohorts (PD-free or hyperglycemia-free) derived from 5,885 subjects aged 35–44 years who were periodically attending a screening program. We ascertained both incident cases of PD (defined by Community Periodontal Index score ≧ 3) and hyperglycemia [fasting plasma glucose (FPG) ≧100 mg/dL] or type 2 diabetes (FPG ≧ 126 mg/dL) with 5-year follow-up. Cox proportional hazards regression model was used to assess the effect of PD on hyperglycemia and vice versa with adjustment for other confounding factors. Participants with PD presented a 33 % increase in their risk of incident hyperglycemia (including diabetes) [adjusted hazard ratio (aHR) = 1.33 (95 % CI 1.09–1.63)] after controlling for potential confounding factors. Conversely, prediabetes and type 2 diabetes mellitus led to a significant elevated risk for PD [aHR = 1.25 (95 % CI 1.00–1.57) and aHR = 1.95 (95 % CI 1.22–3.13)] after adjustment for other confounding factors. In conclusion, a significant bidirectional relationships was found between hyperglycemia and PD, suggesting that both diseases may share common latent traits and pathways that are worthy of being further elucidated by continuing a long-term follow-up of this cohort.

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Abbreviations

KCIS:

Keelung community-based integrated screening

CPI:

Community Periodontal Index

PD:

Periodontal disease

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Acknowledgments

We thank all faculty of the Public Health Center and Division of Health Promotion, Health Bureau of Keelung City, Keelung City, Taiwan for their contribution to the Keelung Community-based Integrated Screening (KCIS).

Conflict of interest

The authors declare that there are no conflicts of interest in this study.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all subjects for being included in this study, which was governed by Health Bureau.

Author information

Authors and Affiliations

  1. Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan

    Sherry Yueh-Hsia Chiu

  2. QC Dental Clinic, Taipei, Taiwan

    Hongmin Lai

  3. Department of Dentistry, National Yang-Ming University, Taipei, Taiwan

    Hongmin Lai

  4. School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

    Hongmin Lai, Amy Ming-Fang Yen & Li-Sheng Chen

  5. Department of Health Industry Management, College of Healthcare Management, Kainan University, Taoyuan, Taiwan

    Jean Ching-Yuan Fann

  6. Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Hsuchow Road, Taipei, 100, Taiwan

    Hsiu-Hsi Chen

Authors
  1. Sherry Yueh-Hsia Chiu
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  2. Hongmin Lai
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  4. Jean Ching-Yuan Fann
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Corresponding author

Correspondence to Hsiu-Hsi Chen.

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Chiu, S.YH., Lai, H., Yen, A.MF. et al. Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35–44 years (KCIS No. 32). Acta Diabetol 52, 123–131 (2015). https://doi.org/10.1007/s00592-014-0612-0

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  • DOI: https://doi.org/10.1007/s00592-014-0612-0

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