Cheng Jing, Jiang Qi, Liu Yang, Zhang Shengdan, Wang You, Lin Dai, Cheng Bo
Department of Stomatology, Zhongnan Hospital of Wuhan University, 169 Donghu Rd, Wuhan, 430071, China.
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
BMC Oral Health. 2025 Jul 16;25(1):1179. doi: 10.1186/s12903-025-06541-x.
This study aimed to explore the relationship between periodontitis and gestational diabetes mellitus (GDM) and to ascertain the role of systemic inflammation in mediating this association.
Data from 5,283 women of reproductive age ranging from 20 to 44 years were retrieved from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 2009-2014 cycles. The female participants were categorized into three groups: non-diabetes, DM, and GDM. Multivariate logistic and linear regression models were employed to assess the correlations between periodontal variables and diabetes status. Additionally, a mediation analysis was performed to explore the role of systemic inflammatory biomarkers.
Compared to non-periodontitis, women with periodontitis have a 1.68 times higher risk of having GDM (OR = 1.68, 95% CI: 1.14-2.50). Clinical attachment level (CAL), the continuous periodontal parameter, also presented a significant association with GDM risk (OR = 1.50, 95% CI: 1.25-1.81 per 1-mm increase). Linear regression analyses further revealed that hemoglobin A1c (HbA1c) levels were positively associated with periodontitis (Beta = 0.19, SE = 0.06, p < 0.01) and CAL (Beta = 0.06, SE = 0.03, p < 0.001), respectively. The association between periodontitis and GDM risk was found to be mediated by white blood cell count (WBC), monocyte count, and monocyte-lymphocyte ratio (MLR), with mediation proportions of 5.02%, 5.88%, and 5.20%, respectively. Similar mediation effects were observed for the CAL-GDM association.
The present study indicated that periodontitis was associated with GDM among women of childbearing age, with systemic inflammation potentially serving as a partial mediator of this association.
本研究旨在探讨牙周炎与妊娠期糖尿病（GDM）之间的关系，并确定全身炎症在介导这种关联中的作用。
从国家健康与营养检查调查（NHANES）III（1988 - 1994年）和NHANES 2009 - 2014年周期中检索了5283名年龄在20至44岁之间的育龄女性的数据。女性参与者被分为三组：非糖尿病组、糖尿病组和妊娠期糖尿病组。采用多变量逻辑回归和线性回归模型评估牙周变量与糖尿病状态之间的相关性。此外，进行中介分析以探讨全身炎症生物标志物的作用。
与非牙周炎患者相比，患有牙周炎的女性患妊娠期糖尿病的风险高1.68倍（OR = 1.68，95% CI：1.14 - 2.50）。临床附着水平（CAL），即连续的牙周参数，也与妊娠期糖尿病风险呈显著关联（每增加1毫米，OR = 1.50，95% CI：1.25 - 1.81）。线性回归分析进一步显示，糖化血红蛋白（HbA1c）水平分别与牙周炎（β = 0.19，SE = 0.06，p < 0.01）和CAL（β = 0.06，SE = 0.03，p < 0.001）呈正相关。发现牙周炎与妊娠期糖尿病风险之间的关联由白细胞计数（WBC）、单核细胞计数和单核细胞 - 淋巴细胞比率（MLR）介导，中介比例分别为5.02%、5.88%和5.20%。对于CAL - 妊娠期糖尿病关联也观察到类似的中介效应。
本研究表明，育龄女性中牙周炎与妊娠期糖尿病相关，全身炎症可能是这种关联的部分中介因素。
