Association between periodontal disease, diabetes and pro-inflammatory genetic polymorphisms

Objective: To investigate associations between periodontal disease (PD), diabetes and pro-inflammatory genetic polymorphisms in subjects with cardiovascular risk.

Methods: Two hundred and fifty five subjects receiving preventive care for cardiovascular disease were screened. A complete periodontal examination was performed and included oral hygiene status, probing depth, bleeding on probing, and clinical attachment loss (CAL). A medical history and family and personal known cardiovascular risk factors were recorded. Plasma levels of C-reactive protein (CRP), fibrinogen, eritrosedimentation rate (ESR) and glycosylated hemoglobin (HbA1c) were measured. Genomic DNA was obtained and analyzed for genotyping of IL-1A (+889), IL-1B (+3954) and (-511), IL-1RN, IL-6 (-174) TNF-alpha (-308) and CRP (+1444) polymorphisms. Differences between diabetics and non-diabetics were statistically analyzed (test-t, chi-square, Fischer's exact test, lineal regression analysis).

Results:Of the 255 subjects, 78 were diabetics and 177 non-diabetics. Prevalence of PD was 92.3% in diabetics and 89.3% in non-diabetics. Frequencies of women, smokers, and subjects without PD were not different between groups. Diabetics versus non-diabetics had higher mean CAL (4.04±1.50 versus 3.46±1.43mm, P=0.004) and higher % of sites with CAL>3mm (73.24±27.34 versus 64.39±29.59mm, P=0.019). Severe PD was associated with poor glycemic control (HbA1c >7%) P=0.001.

The mean levels of CRP, fibrinogen, ESR, and total cholestherol were higher in diabetics, but the differences were not significant. Diabetics had a significant higher frequency of homozygous for allele 1 at the IL-1A(-889) and IL-1B (+3954) (P=0.043),and non diabetics showed a significant higher frequency of heterozygous and homozygous for allele 2 at the IL-1A(-889) P=0.023. No associations between other polymorphisms and PD and diabetes were found.

Conclusions: Diabetics showed more severe PD than non-diabetics. No association between diabetes and pro-inflammatory polymorphisms was found. FONDECYT 1061070 project grant.