Hispanic adults with type 2 diabetes mellitus using lipid-lowering agents have better periodontal health than non-users

Author:

Andriankaja Oelisoa M.1ORCID,Joshipura Kaumudi J.23,Levine Michael A.4,Ramirez-Vick Margarita5,Rivas-Agosto Julio A.2,Duconge Jorge S.6,Graves Dana T.7

Affiliation:

1. Department of Oral Health Practice, College of Dentistry, University of Kentucky, 770 Rose Street, Dental Science Building, Office D-106B3, Lexington, KY 40536, USA

2. Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus University of Puerto Rico, San Juan, Puerto Rico

3. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA

4. Center for Bone Health, Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

5. Endocrinology Section, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico

6. School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico

7. Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA

Abstract

Background: Recent studies suggest that lipid-lowering agents (LLA) may reduce chronic periodontitis, but it is unknown whether this benefit extends to people with type 2 diabetes (T2D). Objective: We assessed the association between LLA use and periodontitis in Hispanic adults with T2D. Design: This was a cross-sectional observational study. Methods: We assessed the association of LLA use and periodontal parameters in 253 Puerto Ricans 40–65 years with T2D who participated in the Lipid-Lowering agents use in Periodontitis and Diabetes Study study. Participants were classified as (a) none- or <1 year, (b) 1–4 years, or (c) >4 years. The primary outcome consists of a tertile percent of sites with probing pocket depth (PPD) ⩾ 4 mm and the secondary outcome includes tertiles of percent sites with clinical attachment loss (CAL) ⩾ 4 mm. Multinomial logistic regression models adjusted for age, gender, smoking status, education, waist circumference, glycosylated hemoglobin A1C (HbA1c), bleeding on probing, examiner, and anti-inflammatory agents were used to estimate the association. Results: LLA (92.5%, statins) was used by 52% of participants. LLA use 1–4 years was associated with lower odds of PPD ⩾ 4 mm (OR: 0.22, p  = 0.005; high versus low tertile) or lower odds of CAL ⩾ 4 mm (OR: 0.33, p  = 0.02, middle versus low tertile), compared to those with LLA minimal or no use. This association was lost for participants who used LLA for >4 years. LLA users for >4 years with periodontal disease had elevated HbA1c (OR: 1.36, p  = 0.05). Conclusion: The use of LLA for 1–4 years was associated with lower values of periodontal parameters versus minimal LLA use. This association was not present among people using LLA > 4 years users, but these participants had poorer glycemic control compared to other participants. In this cross-sectional study, the finding that LLA use 1- 4 years is associated with lower values of periodontal parameters of severity in T2D individuals may help clarify some of the controversies regarding the benefit of these medications in this population.

Funder

National Institute of Health

National Institute of Dental and Craniofacial Research

Publisher

SAGE Publications

Subject

Medicine (miscellaneous)

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