Correlation of periodontal inflamed surface area with glycated hemoglobin, interleukin-6 and lipoprotein(a) in type 2 diabetes with retinopathy

doi:10.4239/wjd.v15.i4.686

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Apr 15, 2024 (publication date) through Nov 25, 2024

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Diabetes. Apr 15, 2024; 15(4): 686-696
Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.686

Table 1 Socio-demographic, behavioral, and clinical characteristics of study subjects

Variables		T2DM with DR (n = 40)	T2DM without DR (n = 40)	P value
Age, yr (mean ± SD)		53.85 ± 6.86	54.03 ± 10.75	0.093
Gender frequency, n (%)	Male	31 (77.5)	17 (42.5)	0.001
Gender frequency, n (%)	Female	9 (22.5)	23 (57.5)	0.001
Education frequency, n (%)	Illiterate	0	1 (2.5)	0.172
	Primary school	5 (12.50)	4 (10)
	Middle school	21 (52.50)	12 (30.0)
	High school	11 (27.50)	21 (52.5)
	Diploma and above	3 (7.5)	2 (5.0)
Socioeconomic status frequency, n (%)	APL	25 (62.5)	19 (47.5)	0.178
Socioeconomic status frequency, n (%)	BPL	15 (37.5)	21 (52.5)	0.178
Behavioural
Smoking status, n (%)	Current smoker	1 (2.5)	1 (2.5)	0.49
	Ex-smoker	5 (12.5)	2 (5.0)
	Non-smoker	34 (85.0)	37 (92.5)
Frequency of teeth cleaning (daily), n (%)	Once	23 (57.5)	19 (47.5)	0.44
	Twice	17 (42.5)	20 (50.0)
	After every meal	0 (0)	1 (2.5)
Clinical (mean ± SD)
Duration of DM (yr)		11.94 ± 6.83	8.07 ± 4.87	0.005^a
DI-S		1.78 ± 0.69	1.22 ± 0.54	< 0.001^a
CI-S		1.15 ± 0.79	1.00 ± 0.67	0.36
OHI-S		2.90 ± 1.38	2.22 ± 1.12	0.02^a
PI		1.72 ± 0.57	1.54 ± 0.62	0.19
DMFT		7.48 ± 4.08	5.53 ± 4.45	0.04^a

^aP <0.05.

T2DM: Type 2 diabetes mellitus; DR: Diabetic retinopathy; APL: Above the poverty line; BPL: Below the poverty line; DM: Diabetes mellitus; CI-S: Calculus index-simplified; DI-S: Debris index-simplified; DMFT: Decayed, missing, filled teeth; OHI-S: Oral hygiene index-simplified; PI: Plaque index.

Table 2 Comparison of biochemical and periodontal variables between groups

Variables	T2DM with DR (n = 40)	T2DM without DR (n = 40)	P value
HbA1c (%)	8.67 ± 1.81	7.64 ± 1.28	0.004^a
FPG (mmol/L)	8.66 ± 2.67	8.62 ± 3.58	0.95
PPG (mmol/L)	12.22 ± 4.21	11.95 ± 4.05	0.77
IL-6 (pg/mL)	30.52 ± 16.57	13.47 ± 4.15	< 0.001^a
Lp(a) (mg/dL)	27.76 ± 18.82	11.45 ± 9.08	< 0.001^a
Total cholesterol (mmol/L)	4.93 ± 0.90	4.70 ± 0.89	0.254
HDL (mmol/L)	1.41 ± 0.34	1.78 ± 0.36	< 0.001^a
LDL (mmol/L)	2.80 ± 0.93	2.31 ± 0.97	0.025 ^a
VLDL (mmol/L)	0.76 ± 0.28	0.61 ± 0.19	0.005 ^a
TG (mmol/L)	1.67 ± 0.61	1.32 ± 0.41	0.004 ^a
Periodontal variables
PPD (mm)	3.87 ± 0.93	3.08 ± 0.66	< 0.001^a
CAL (mm)	4.50 ± 1.49	3.43 ± 0.85	< 0.001^a
CAL, ≤ 3 mm	36.14 ± 22.81	63.88 ± 26.52	< 0.001^a
CAL, 4 to 5 mm	40.62 ± 15.56	28.91 ± 18.55	0.003^a
CAL, ≥ 6 mm	23.42 ± 24.29	8.44 ± 11.99	0.001^a
BOP (% of sites)	69.33 ± 23.36	40.95 ± 25.47	< 0.001^a
PISA (mm²)	1570.559 ± 759.89	789.79 ± 589.34	< 0.001^a
Periodontitis, n (%)	19 (47.5)	11 (27.5)	0.065

^aP < 0.05.

A significant difference among subjects with type 2 diabetes mellitus in glycated hemoglobin, interleukin-6, lipoprotein(a), high density lipoprotein, low density lipoprotein, very low-density lipoprotein, triglyceride, periodontal disease, clinical attachment loss (CAL), CAL ≤ 3 mm, CAL ≥ 6 mm, bleeding on probing, periodontal inflamed surface area, and severity of periodontitis. T2DM: Type 2 diabetes mellitus; DR: Diabetic retinopathy; HbA1c: Glycated hemoglobin; FPG: Fasting plasma glucose; PPG: Postprandial plasma glucose; Il-6: Interleukin-6; Lp(a): Lipoprotein(a); HDL: High density lipoprotein; LDL: Low density lipoprotein; VLDL: Very low-density lipoprotein; TG: Triglyceride; PPD: Probing pocket Depth; CAL: Clinical attachment loss; BOP: Bleeding on probing; PISA: Periodontal inflamed surface area.

Table 3 Comparison of clinical attachment loss and periodontal inflamed surface area among nonproliferative, proliferative and no retinopathy in type 2 diabetes mellitus patients

Variable	Non-proliferative diabetic retinopathy	Proliferative diabetic retinopathy	Diabetic without retinopathy	P value
Mean CAL (mm, 95%CI)	4.1 (3.66-4.72)	4.87 (4.00-5.75)	3.43 (3.15-3.70)	< 0.001^a
Mean PISA (mm², 95%CI)	1380.87 (1087.12-1674.63)	1802.39 (1392.62-2212.17)	789.79 (601.31-978.27)	< 0.001^a

^aP < 0.05.

A significant difference in clinical attachment loss and periodontal inflamed surface area among non-proliferative, proliferative and no diabetic retinopathy. CAL: Clinical attachment loss; PISA: Periodontal inflamed surface area.

Table 4 Bonferroni post-hoc adjustment

Dependent variable	Group	Group	Mean difference (95%CI)	P value	F statistic
Mean CAL	1	2	-0.68 (-1.61, 0.25)	0.23	9.58
		3	0.76 (-0.01, 1.54)	0.05^a
	2	3	1.44 (0.61, 2.28)	< 0.001^a
Mean PISA	1	2	-421.52 (-940.717, 97.681)	0.15	15.65
		3	591.08 (157.464, 1024.697)	0.004^a
	2	3	1012.59 (548.94, 1476.258)	< 0.001^a

^aP < 0.05.

A significant difference in clinical attachment loss and periodontal inflamed surface area among non-proliferative, proliferative and no diabetic retinopathy. Group 1: Nonproliferative diabetic retinopathy; Group 2: Proliferative diabetic retinopathy; Group 3: Type 2 diabetes without retinopathy. CAL: Clinical attachment loss; PISA: Periodontal inflamed surface area.

Citation: Thazhe Poyil NJ, Vadakkekuttical RJ, Radhakrishnan C. Correlation of periodontal inflamed surface area with glycated hemoglobin, interleukin-6 and lipoprotein(a) in type 2 diabetes with retinopathy. World J Diabetes 2024; 15(4): 686-696
URL: https://www.wjgnet.com/1948-9358/full/v15/i4/686.htm
DOI: https://dx.doi.org/10.4239/wjd.v15.i4.686