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Meta-Analysis
. 2020 Jul 11;20(1):204.
doi: 10.1186/s12903-020-01180-w.

Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

Chen-Zhou Wu  1 , Yi-Hang Yuan  1 , Hang-Hang Liu  2 , Shen-Sui Li  1 , Bo-Wen Zhang  1 , Wen Chen  1 , Zi-Jian An  1 , Si-Yu Chen  1 , Yong-Zhi Wu  1 , Bo Han  1 , Chun-Jie Li  1 , Long-Jiang Li  3
Affiliations
Meta-Analysis

Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

Chen-Zhou Wu et al. BMC Oral Health. .

Abstract

Background: To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM).

Methods: Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA.

Results: A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust.

Conclusions: There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other's incidence.

Keywords: Diabetes mellitus, type 2; Epidemiologic studies; Meta-analysis; Periodontitis; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study selection
Fig. 2
Fig. 2
Meta-analyses of cross-sectional studies. (a) Results of adjusted ORs on T2DM prevalence (b) Results of adjusted ORs on periodontitis prevalence (c) Results of crude CAL (d) Results of crude PPD (e) Results of crude NOT (f) Results of crude LOT
Fig. 3
Fig. 3
The impact of T2DM on periodontitis incidence. (a) Meta-analysis of periodontitis incidence (b) Meta-analysis of periodontitis incidence based on the level of glycemic control
Fig. 4
Fig. 4
The impact of periodontitis on T2DM incidence. (a) Meta-analysis based on mild periodontitis (b) Meta-analysis based on severe periodontitis
See this image and copyright information in PMC

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