Im Yu-Na, Kim Na-Yeong, Chung Ki-Ho
Chonnam National University School of Dentistry, Gwangju, Republic of Korea.
Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju, Republic of Korea.
J Periodontol. 2025 Jul 8. doi: 10.1002/JPER.24-0490.
Non-insulin-based insulin resistance indices provide a cost-effective assessment of insulin resistance. As periodontitis has a bidirectional relationship with diabetes, this study used these indices to analyze the association between insulin resistance and periodontitis and compared their diagnostic accuracy.
The study used healthcare big data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2018). Periodontitis was determined based on the Community Periodontal Index (CPI). Among the indices, triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), metabolic score for insulin resistance (METS-IR), triglyceride glucose index (TyG), TyG adjusted with body mass index, TyG adjusted with waist circumference (WC), and TyG adjusted with waist-to-height ratio (WHtR) were compared. A multivariate logistic regression model was constructed by dividing the data into quartiles, and receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracy.
The prevalence of periodontitis increased with increasing quartile of the insulin resistance index. The multivariate logistic regression analysis showed that insulin resistance and periodontitis were significantly associated in the fourth quartile for all indicators (p < 0.05). In particular, the area under the curve (AUC) value of the TyG adjusted with WHtR was the highest at 0.64, implying that it had the best diagnostic accuracy among the compared indices.
TyG-related indices were associated with the prevalence of periodontitis, and the TyG adjusted for WHtR showed the greatest diagnostic accuracy for periodontitis.
This study looked at the association between a measure called the triglyceride glucose index (TyG) and periodontitis using data from 22,994 people in South Korea. The TyG helps to identify insulin resistance, a condition where the body does not respond well to insulin, which is crucial for controlling blood sugar levels. Unlike traditional tests that require blood samples and are time-consuming, the TyG is simpler and cheaper. Our research found an association between insulin resistance and periodontitis. Among the different versions of the TyG, the one that combined the TyG with the waist-to-height ratio (TyGWHtR) was the most accurate in identifying those who might have periodontitis. This means that using the TyGWHtR could be a helpful way to find and help people who are at risk for insulin resistance and potentially improve their oral health early on.
非胰岛素依赖型胰岛素抵抗指数为胰岛素抵抗提供了一种经济有效的评估方法。由于牙周炎与糖尿病存在双向关系，本研究使用这些指数来分析胰岛素抵抗与牙周炎之间的关联，并比较它们的诊断准确性。
本研究使用了韩国国家健康与营养检查调查（KNHANES，2013 - 2018年）的医疗大数据。根据社区牙周指数（CPI）确定牙周炎。在这些指数中，比较了甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、胰岛素抵抗代谢评分（METS-IR）、甘油三酯葡萄糖指数（TyG）、根据体重指数调整的TyG、根据腰围（WC）调整的TyG以及根据腰高比（WHtR）调整的TyG。通过将数据分为四分位数构建多因素逻辑回归模型，并进行受试者工作特征（ROC）分析以比较诊断准确性。
牙周炎的患病率随着胰岛素抵抗指数四分位数的增加而升高。多因素逻辑回归分析表明，所有指标在第四四分位数时胰岛素抵抗与牙周炎均显著相关（p < 0.05）。特别是，根据WHtR调整的TyG的曲线下面积（AUC）值最高，为0.64，这意味着在比较的指数中它具有最佳的诊断准确性。
与TyG相关的指数与牙周炎的患病率相关，并且根据WHtR调整的TyG对牙周炎具有最大的诊断准确性。
本研究利用来自韩国22994人的数据，研究了一种名为甘油三酯葡萄糖指数（TyG）的指标与牙周炎之间的关联。TyG有助于识别胰岛素抵抗，胰岛素抵抗是一种身体对胰岛素反应不佳的状况，而胰岛素对控制血糖水平至关重要。与需要采集血样且耗时的传统检测不同，TyG更简单、成本更低。我们的研究发现胰岛素抵抗与牙周炎之间存在关联。在不同版本的TyG中，将TyG与腰高比（TyGWHtR）相结合的版本在识别可能患有牙周炎的人群方面最为准确。这意味着使用TyGWHtR可能是一种有助于发现和帮助有胰岛素抵抗风险的人群，并可能早期改善其口腔健康的有用方法。
