Periodontitis tied to diabetic retinopathy among nonobese diabetic adults

17 Apr 2017
Periodontitis tied to diabetic retinopathy among nonobese diabetic adults

The presence of periodontitis in nonobese diabetic adults appears to be positively associated with diabetic retinopathy, according to a study.

Researchers drew data from the Korean National Health and Nutrition Examination Survey of the Korean population conducted between 2008 and 2010, and examined the presence of diabetic retinopathy in relation to demographic variables and anthropometric characteristics of the participants. Assessments of the presence of periodontitis and presence of retinopathy were categorized by body mass index (BMI): <25 kg/m2 and ≥25 kg/m2.

Analysis was performed using multiple logistic regression models. Variables including age, sex, smoking, drinking, exercise, hypertension, metabolic syndrome, HbA1c, and duration of diabetes mellitus were included as confounders.

The study population comprised 1,138 individuals with type 2 diabetes, of which 13.3 percent had diabetic retinopathy. Results showed a statistically significant increase in the prevalence of periodontitis among individuals with proliferative diabetic retinopathy and clinically significant macular oedema in the <25 kg/m2 group.

The adjusted odds ratios for prevalence of diabetic retinopathy were 1.193 (95 percent CI, 0.757 to 1.881) in the entire population, 2.206 (1.114 to 4.366) in the subgroup of individuals with BMI <25 kg/m2 and 0.588 (0.326 to 1.061) in the subgroup of those with BMI ≥25 kg/m2.

Diabetic retinopathy is among the most common microvascular complications of diabetes mellitus, which is, in turn, a risk factor for periodontal disease. Compared with healthy individuals, diabetic patients commonly develop more extensive and severe gingivitis and periodontitis. [Diabetes Rev 2011;7:433–439; Arch Ophthalmol 2008;126:1740–1747]

“The mechanisms for the association of diabetic retinopathy with the presence of periodontitis in nonobese diabetic participants may be explained partially by the differences between obese and nonobese patients in type 2 diabetes mellitus,” researchers said.

They explained that despite a normal BMI, nonobese patients with type 2 diabetes are generally characterized by a higher degree of both abdominal and total fat masses (adiposity). Abdominal obesity could adversely affect blood vessels, and diabetic patients with abdominal obesity has been shown to exhibit peripheral insulin resistance in combination with defective insulin secretion. [Cardiovasc Diabetol 2014;13:141; Appl Physiol Nutr Metab 2007;32:912–920]

The present data highlight the need for timely ophthalmic evaluation of nonobese diabetic patients who have periodontitis.

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