ABSTRACT
Background: diabetes and periodontitis are common comorbidities; however, the clinical implications of this association remain only partially known. This study was aimed to characterize the periodontal status of type 2 diabetic (T2D) patients and its correlation with metabolic and inflammatory parameters. Methods: patients (n = 30) with 5 or less years since the diagnosis of T2D (18 65 years old) were recruited. Anthropometric (Body Mass Index, BMI), metabolic (fasting glucose, glycated hemoglobin, insulin, HOMA-IR, HDL, LDL and total cholesterol, triglycerides) and inflammatory parameters (ultrasensitive C reactive protein, usCRP) were quantified. Periodontal evaluation included clinical attachment level (CAL), probing depth (PD), gingival level (GL) and bleeding on probing (BOP) average. Statistical significance was assessed by Mann-Whitney and Spearman correlation tests. Results: mean values of BOP, CAL, PD and GL were 39.3, 2.8, 2.8, and 0.1, respectively. BOP significantly correlated with BMI and HOMA-IR and was higher in patients with elevated usCRP >3 mg/L (p<0.05). Age and duration of T2D directly and inversely correlated with CAL and GL, respectively. BOP correlated with HOMA-IR and usCRP but not with patients´age, duration of T2D or BMI. Conclusions: in patients with recent diagnosis of T2D, BOP is associated with usCRP and HOMA-IR levels, suggesting that periodontal inflammation promotes insulin resistance possibly by increasing systemic inflammation. (AU)
Antecedentes: la diabetes y la periodontitis son comorbilidades comunes; sin embargo, las implicaciones clínicas de esta asociación siguen siendo solo parcialmente conocidas. El objetivo de este estudio fue caracterizar el estado periodontal de los pacientes con diabetes tipo 2 (T2D) y su correlación con los parámetros metabólicos e inflamatorios. Métodos: se reclutaron pacientes (n = 30) con 5 años o menos desde el diagnóstico de DM2 (18-65 años). Se cuantificaron parámetros antropométricos (índice de masa corporal, IMC), metabólicos (glucosa en ayunas, hemoglobina glucosilada, insulina, HOMA-IR, HDL, LDL y colesterol total, triglicéridos) y parámetros inflamatorios (proteína reactiva C ultrasensible, usCRP). La evaluación periodontal incluyó el nivel de inserción clínica (CAL), la profundidad de sondaje (PD), el nivel gingival (GL) y el promedio de sangrado al sondaje (BOP). La significación estadística se evaluó mediante pruebas de correlación de Mann-Whitney y Spearman. Resultados: los valores medios de BOP, CAL, PD y GL fueron 39.3, 2.8, 2.8 y 0.1, respectivamente. La BOP se correlacionó significativamente con el IMC y el HOMA-IR y fue mayor en pacientes con una usCRP elevada> 3 mg / L (p <0.05). La edad y la duración de T2D se correlacionaron directa e inversamente con CAL y GL, respectivamente. La BOP se correlacionó con HOMA-IR y usCRP pero no con la edad de los pacientes, la duración de T2D o IMC. Conclusiones: en pacientes con diagnóstico reciente de T2D, la BOP está asociada con los niveles de usCRP y HOMA-IR, lo que sugiere que la inflamación periodontal promueve la resistencia a la insulina posiblemente al aumentar la inflamación sistémica. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Periodontitis , Diabetes Mellitus, Type 2 , C-Reactive Protein , Insulin Resistance , Chronic Disease , Diagnosis , InflammationABSTRACT
Background: Visceral fat accumulation is associated with the development of metabolic diseases. Anthropometry is one of the methods used to quantify it. aim: to evaluate the relationship between visceral adipose tissue volume (VAT), measured with magnetic resonance imaging (MRI), and anthropometric indexes, such as body mass index (BMI) and waist circumference (WC), in type 2 diabetic patients (DM2). Patients and Methods: Twenty four type 2 diabetic patients aged 55 to 78 years (15 females) and weighting 61.5 to 97 kg, were included. The patients underwent MRI examination on a Philips Intera® 1.5T MR scanner. The MRI protocol included a spectral excitation sequence centered at the fat peak. The field of view included from L4-L5 to the diaphragmatic border. VAT was measured using the software Image J®. Weight, height, BMI, WC and body fat percentage (BF%), derived from the measurement offour skinfolds with the equation of Durnin and Womersley, were also measured. The association between MRIVAT measurement and anthropometry was evaluated using the Pearson's correlation coefficient. Results: Mean VAT was 2478 ± 758 ml, mean BMI29.5 ± 4.7 kg/m², and mean WC was 100 ± 9.7 cm. There was a poor correlation between VAT, BMI (r = 0.18) and WC (r = 0.56). Conclusions: BMI and WC are inaccurate predictors of VAT volume in type 2 diabetic patients.