Journal of applied oral science : revista FOB · 2026
Association of periodontitis stages with glycemic control in adults with and without type 2 diabetes mellitus: a cross-sectional study.
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Rodrigues Maria Eduarda Oliveira, Vilarinho Josy Lorena Peres da Silva, Chermont João Gabriel Jucá, Stefani Cristine Miron, Carneiro Valéria Martins de Araújo, Guimarães Maria do Carmo Machado, Greggianin Bruna Frizon
Аннотация
OBJECTIVE: To investigate associations among periodontal parameters, glycated hemoglobin (HbA1c), and metabolic parameters in adults with and without type 2 diabetes mellitus (T2D).
METHODOLOGY: A cross-sectional study included 74 adults diagnosed with periodontitis according to the current periodontal classification of 2018. Participants underwent a full-mouth periodontal examination, laboratory assessment, and Body Mass Index (BMI). Periodontitis was categorized into Stages I/II and Stages III/IV. HbA1c, lipid profile, high-sensitivity C-reactive protein (CRP), and insulin resistance (HOMA-IR) were assessed. Periodontal inflammatory burden was quantified using the Periodontal Inflamed Surface Area (PISA). Non-parametric tests and Spearman correlation analyses were performed, stratified by diabetes status (α=5%).
RESULTS: Individuals with advanced periodontitis (Stages III/IV) had significantly higher HbA1c levels (6.8% vs. 5.8%; p=0.007), higher triglyceride concentrations (142.0 vs. 100.5 mg/dL; p=0.016), and lower HDL-cholesterol levels (46.0 vs. 52.0 mg/dL; p=0.012) than those in Stages I/II. Poor glycemic control (HbA1c >8.5%) and T2D duration ≥10 years were significantly associated with advanced stages (p<0.05). No significant differences were observed for BMI, LDL, total cholesterol (TC), CRP, or HOMA-IR between groups. In adults with T2D, PISA correlated positively with TC and LDL-cholesterol, whereas in non-diabetic individuals, PISA was associated primarily with triglycerides.
CONCLUSIONS: Advanced periodontitis was associated with poorer glycemic control and a more atherogenic lipid profile, particularly characterized by elevated triglycerides and reduced HDL-cholesterol. The findings support periodontitis as a potential marker of systemic metabolic dysregulation and reinforce the importance of integrating periodontal care into cardiometabolic risk management strategies.
METHODOLOGY: A cross-sectional study included 74 adults diagnosed with periodontitis according to the current periodontal classification of 2018. Participants underwent a full-mouth periodontal examination, laboratory assessment, and Body Mass Index (BMI). Periodontitis was categorized into Stages I/II and Stages III/IV. HbA1c, lipid profile, high-sensitivity C-reactive protein (CRP), and insulin resistance (HOMA-IR) were assessed. Periodontal inflammatory burden was quantified using the Periodontal Inflamed Surface Area (PISA). Non-parametric tests and Spearman correlation analyses were performed, stratified by diabetes status (α=5%).
RESULTS: Individuals with advanced periodontitis (Stages III/IV) had significantly higher HbA1c levels (6.8% vs. 5.8%; p=0.007), higher triglyceride concentrations (142.0 vs. 100.5 mg/dL; p=0.016), and lower HDL-cholesterol levels (46.0 vs. 52.0 mg/dL; p=0.012) than those in Stages I/II. Poor glycemic control (HbA1c >8.5%) and T2D duration ≥10 years were significantly associated with advanced stages (p<0.05). No significant differences were observed for BMI, LDL, total cholesterol (TC), CRP, or HOMA-IR between groups. In adults with T2D, PISA correlated positively with TC and LDL-cholesterol, whereas in non-diabetic individuals, PISA was associated primarily with triglycerides.
CONCLUSIONS: Advanced periodontitis was associated with poorer glycemic control and a more atherogenic lipid profile, particularly characterized by elevated triglycerides and reduced HDL-cholesterol. The findings support periodontitis as a potential marker of systemic metabolic dysregulation and reinforce the importance of integrating periodontal care into cardiometabolic risk management strategies.
Предметные рубрики MeSH
HumansCross-Sectional StudiesDiabetes Mellitus, Type 2FemaleGlycated HemoglobinMaleMiddle AgedC-Reactive ProteinGlycemic ControlPeriodontitisBody Mass IndexBlood GlucoseStatistics, NonparametricAdultInsulin ResistancePeriodontal IndexTriglyceridesRisk FactorsCholesterol, HDLReference ValuesLipidsAgedSeverity of Illness Index