Association of Periodontal Destruction and Diabetes with Mortality

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Association of Periodontal Destruction and Diabetes with Mortality. / Kebede, T.G.; Holtfreter, Birte; Kocher, Thomas; Meisel, P; Dietrich, Thomas; Biffar, R; Dorr, M; Völzke, Henry; Pink, C.

In: Journal of Dental Research, 28.09.2016.

Research output: Contribution to journalArticlepeer-review

Harvard

Kebede, TG, Holtfreter, B, Kocher, T, Meisel, P, Dietrich, T, Biffar, R, Dorr, M, Völzke, H & Pink, C 2016, 'Association of Periodontal Destruction and Diabetes with Mortality', Journal of Dental Research. https://doi.org/10.1177/0022034516668839

APA

Kebede, T. G., Holtfreter, B., Kocher, T., Meisel, P., Dietrich, T., Biffar, R., Dorr, M., Völzke, H., & Pink, C. (2016). Association of Periodontal Destruction and Diabetes with Mortality. Journal of Dental Research. https://doi.org/10.1177/0022034516668839

Vancouver

Author

Kebede, T.G. ; Holtfreter, Birte ; Kocher, Thomas ; Meisel, P ; Dietrich, Thomas ; Biffar, R ; Dorr, M ; Völzke, Henry ; Pink, C. / Association of Periodontal Destruction and Diabetes with Mortality. In: Journal of Dental Research. 2016.

Bibtex

@article{ba2f999d2d794b8a9bb660f44c77afc7,
title = "Association of Periodontal Destruction and Diabetes with Mortality",
abstract = "Current evidence indicates the effects of periodontitis on diabetes as well as mortality, for which diabetes itself represents a risk factor. However, the possible interaction of these 2 chronic conditions regarding mortality has not yet been investigated. Therefore, the purpose of this study was to evaluate whether periodontal destruction interacts with diabetes on all-cause and cardiovascular disease (CVD) mortality or if diabetes serves as a mediator in this association. The study sample comprised 3,327 participants aged 20 to 81 y from the Study of Health in Pomerania. Periodontal destruction was assessed via clinical attachment level (CAL) and the number of missing teeth. Information on mortality (date and ICD-10 code) was ascertained from death certificates. Directed acyclic graphs were used to identify potential confounders, and Cox proportional hazard models were applied. In 36,701 person-years of follow-up, 263 study participants deceased, 89 due to CVD. Fully adjusted main effect models resulted in hazard ratios of 1.01 (95% confidence interval [95% CI]: 1.002 to 1.01) for extent of CAL ≥3 mm, 1.10 (95% CI: 1.03 to 1.18) for mean CAL, and 1.03 (95% CI: 1.01 to 1.04) for the number of missing teeth regarding all-cause mortality. Analogous results were obtained for CVD mortality, with hazard ratios of 1.01 (95% CI: 0.99 to 1.02), 1.10 (95% CI: 0.98 to 1.23), and 1.02 (95% CI: 0.99 to 1.05) for extent of CAL, mean CAL, and the number of missing teeth, respectively. Findings did not indicate additive interaction of periodontal destruction and diabetes regarding all-cause and CVD mortality. Similarly, no substantial evidence was found to demonstrate the presence of multiplicative interaction or mediation. Besides adjustment for baseline covariates, time-varying covariates were also considered and led to comparable results. In summary, despite their reciprocal relationship, periodontal destruction and diabetes may be independent risk factors for all-cause and CVD mortality. ",
keywords = "periodontal disease, cardiovascular disease, oral-systemic association, cohort study, glycemic control, systemic inflammation",
author = "T.G. Kebede and Birte Holtfreter and Thomas Kocher and P Meisel and Thomas Dietrich and R Biffar and M Dorr and Henry V{\"o}lzke and C. Pink",
year = "2016",
month = sep,
day = "28",
doi = "10.1177/0022034516668839",
language = "English",
journal = "Journal of Dental Research",
issn = "0022-0345",
publisher = "SAGE Publications",

}

RIS

TY - JOUR

T1 - Association of Periodontal Destruction and Diabetes with Mortality

AU - Kebede, T.G.

AU - Holtfreter, Birte

AU - Kocher, Thomas

AU - Meisel, P

AU - Dietrich, Thomas

AU - Biffar, R

AU - Dorr, M

AU - Völzke, Henry

AU - Pink, C.

PY - 2016/9/28

Y1 - 2016/9/28

N2 - Current evidence indicates the effects of periodontitis on diabetes as well as mortality, for which diabetes itself represents a risk factor. However, the possible interaction of these 2 chronic conditions regarding mortality has not yet been investigated. Therefore, the purpose of this study was to evaluate whether periodontal destruction interacts with diabetes on all-cause and cardiovascular disease (CVD) mortality or if diabetes serves as a mediator in this association. The study sample comprised 3,327 participants aged 20 to 81 y from the Study of Health in Pomerania. Periodontal destruction was assessed via clinical attachment level (CAL) and the number of missing teeth. Information on mortality (date and ICD-10 code) was ascertained from death certificates. Directed acyclic graphs were used to identify potential confounders, and Cox proportional hazard models were applied. In 36,701 person-years of follow-up, 263 study participants deceased, 89 due to CVD. Fully adjusted main effect models resulted in hazard ratios of 1.01 (95% confidence interval [95% CI]: 1.002 to 1.01) for extent of CAL ≥3 mm, 1.10 (95% CI: 1.03 to 1.18) for mean CAL, and 1.03 (95% CI: 1.01 to 1.04) for the number of missing teeth regarding all-cause mortality. Analogous results were obtained for CVD mortality, with hazard ratios of 1.01 (95% CI: 0.99 to 1.02), 1.10 (95% CI: 0.98 to 1.23), and 1.02 (95% CI: 0.99 to 1.05) for extent of CAL, mean CAL, and the number of missing teeth, respectively. Findings did not indicate additive interaction of periodontal destruction and diabetes regarding all-cause and CVD mortality. Similarly, no substantial evidence was found to demonstrate the presence of multiplicative interaction or mediation. Besides adjustment for baseline covariates, time-varying covariates were also considered and led to comparable results. In summary, despite their reciprocal relationship, periodontal destruction and diabetes may be independent risk factors for all-cause and CVD mortality.

AB - Current evidence indicates the effects of periodontitis on diabetes as well as mortality, for which diabetes itself represents a risk factor. However, the possible interaction of these 2 chronic conditions regarding mortality has not yet been investigated. Therefore, the purpose of this study was to evaluate whether periodontal destruction interacts with diabetes on all-cause and cardiovascular disease (CVD) mortality or if diabetes serves as a mediator in this association. The study sample comprised 3,327 participants aged 20 to 81 y from the Study of Health in Pomerania. Periodontal destruction was assessed via clinical attachment level (CAL) and the number of missing teeth. Information on mortality (date and ICD-10 code) was ascertained from death certificates. Directed acyclic graphs were used to identify potential confounders, and Cox proportional hazard models were applied. In 36,701 person-years of follow-up, 263 study participants deceased, 89 due to CVD. Fully adjusted main effect models resulted in hazard ratios of 1.01 (95% confidence interval [95% CI]: 1.002 to 1.01) for extent of CAL ≥3 mm, 1.10 (95% CI: 1.03 to 1.18) for mean CAL, and 1.03 (95% CI: 1.01 to 1.04) for the number of missing teeth regarding all-cause mortality. Analogous results were obtained for CVD mortality, with hazard ratios of 1.01 (95% CI: 0.99 to 1.02), 1.10 (95% CI: 0.98 to 1.23), and 1.02 (95% CI: 0.99 to 1.05) for extent of CAL, mean CAL, and the number of missing teeth, respectively. Findings did not indicate additive interaction of periodontal destruction and diabetes regarding all-cause and CVD mortality. Similarly, no substantial evidence was found to demonstrate the presence of multiplicative interaction or mediation. Besides adjustment for baseline covariates, time-varying covariates were also considered and led to comparable results. In summary, despite their reciprocal relationship, periodontal destruction and diabetes may be independent risk factors for all-cause and CVD mortality.

KW - periodontal disease

KW - cardiovascular disease, oral-systemic association

KW - cohort study

KW - glycemic control

KW - systemic inflammation

U2 - 10.1177/0022034516668839

DO - 10.1177/0022034516668839

M3 - Article

JO - Journal of Dental Research

JF - Journal of Dental Research

SN - 0022-0345

ER -