University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico.
University of Washington, School of Dentistry and School of Public Health, Seattle, WA.
J Periodontol. 2018 May;89(5):549-557. doi: 10.1002/JPER.17-0384.
Evaluate whether insulin resistance (IR) predicts the risk of oral inflammation, assessed as the number of sites with bleeding on probing (BOP) and number of teeth with probing pocket depths (PPD) ≥ 4 mm and BOP.
Data on 870 overweight/obese diabetes free adults, aged 40-65 years from the San Juan Overweight Adults Longitudinal Study over a three-year period, was analyzed. Baseline IR, assessed using the Homeostasis Model Assessment of IR (HOMA-IR) index, was divided into tertiles. BOP was assessed at buccal and lingual sites, and PPD at six sites per tooth. Negative binomial regression was used to estimate the risk ratios (RRs) for oral inflammation adjusted for baseline age, gender, smoking status, alcohol intake, education, physical activity, waist circumference, mean plaque index, and baseline number of sites with BOP, or number of teeth with PPD≥4 mm and BOP. The potential impact of tertiles of serum TNF-α and adiponectin on the IR-oral inflammation association was also assessed in a subsample of 597 participants.
Participants in the highest HOMA-IR tertile at baseline had significantly higher numbers of sites with BOP [RR = 1.19, 95% confidence interval (CI): 1.03-1.36] and number of teeth with PPD ≥ 4 mm and BOP (RR = 1.39, 95% CI: 1.09-1.78) at follow-up, compared with individuals in the lower two HOMA-IR tertiles. Neither TNF-α nor adiponectin confounded the associations.
IR significantly predicts gingival/periodontal inflammation in this population.
评估胰岛素抵抗（IR）是否可预测口腔炎症风险，以探诊出血（BOP）和探诊深度（PPD）≥4 mm 及 BOP 的牙齿数评估。
分析了来自圣胡安超重成年人纵向研究的 870 名超重/肥胖、年龄 40-65 岁、无糖尿病的成年人 3 年的数据。使用稳态模型评估的胰岛素抵抗（HOMA-IR）指数评估基线 IR，并将其分为三分位。在颊侧和舌侧评估 BOP，在每个牙齿的 6 个位点评估 PPD。采用负二项回归估计调整基线年龄、性别、吸烟状况、饮酒量、教育程度、身体活动、腰围、平均菌斑指数以及基线 BOP 位点数或 PPD≥4 mm 及 BOP 牙齿数后的口腔炎症风险比（RR）。还在 597 名参与者的亚样本中评估了血清 TNF-α和脂联素三分位数对 IR 与口腔炎症关联的潜在影响。
与低两个 HOMA-IR 三分位组相比，基线时 HOMA-IR 最高三分位组的 BOP 位点数[RR=1.19，95%置信区间（CI）：1.03-1.36]和 PPD≥4 mm 及 BOP 牙齿数（RR=1.39，95%CI：1.09-1.78）明显更高。TNF-α和脂联素均未混淆关联。
IR 可显著预测该人群的牙龈/牙周炎症。
