Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 19;25(1):404.
doi: 10.1186/s12903-025-05752-6.

Association between the indicators of insulin resistance and periodontitis: a study using data from the National Health and Nutrition Examination Survey 2009-2014

Yiyuan Lang #  1   2 , Xin Song #  3 , Yan Chen  3 , Han Mei  3   4 , Chengyu Wu  3 , Rui Zhang  5 , Changao Xue  6   7
Affiliations

Association between the indicators of insulin resistance and periodontitis: a study using data from the National Health and Nutrition Examination Survey 2009-2014

Yiyuan Lang et al. BMC Oral Health. .

Abstract

Background: The rising obesity rates are accompanied by an increasing prevalence of insulin resistance (IR) associated with obesity. To ascertain the best index for replacing IR, this study aimed to investigate the possible association between IR, which was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and the triglyceride-glucose (TyG) index and its derived indexes and periodontitis.

Methods: The association between the indicators of IR and periodontitis was assessed via multivariate-adjusted logistic regression analyses using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. In addition, subgroup analyses and receiver operating characteristic curve analyses were conducted to explore possible influencing factors.

Results: Our study encompassed 1,588 participants, and 41.0% were diagnosed with periodontitis. Based on the multivariate logistic regression analysis, a higher TyG-waist-to-height ratio (WHtR) (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.02-1.27, P = 0.0244) and HOMA-IR score (OR = 1.00, 95% CI: 1.00-1.00, P = 0.0028) were associated with an increased risk of periodontitis. Conversely, the TyG index, TyG-adjusted for body mass index, and TyG-adjusted for waist circumference (WC) were not associated with periodontitis. According to further subgroup analyses and interaction result analyses, sex affected the association between the TyG index, TyG-WC, and TyG-WHtR and periodontitis (P < 0.05 for interaction). Moreover, the influence of age regulated the association between periodontitis and both TyG and HOMA-IR score. In terms of diagnostic accuracy, the area under the receiver operating characteristic curve analysis revealed that HOMA-IR score and TyG-WHtR slightly outperformed the TyG index, TyG-body mass index, and TyG-WC. Thus, they can be robust markers for assessing IR-related periodontitis risk.

Conclusion: A consistent and positive association was found between HOMA-IR score and TyG-WHtR and the odds of periodontitis prevalence. Hence, HOMA-IR score and TyG-WHtR were significantly associated with periodontitis in this cross-sectional study. However, prospective studies are needed to determine whether higher TyG-waist-to-height ratio and HOMA-IR score can predict the occurrence of periodontitis.

Keywords: A cross-sectional study; NHANES; Periodontitis; Relationship; TyG-related indicators.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted by the Declaration of Helsinki and was approved by the Institutional Review Board of the National Centre for Health Statistics. All participants provided informed consent before enrollment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the sample selection from NHANES 2009–2014
Fig. 2
Fig. 2
The ROC curves of the indicators of insulin resistance for diagnosing periodontitis
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Arboleda S, Vargas M, Losada S, Pinto A. Review of obesity and periodontitis: an epidemiological view. Br Dent J. 2019;227(3):235–9. 10.1038/s41415-019-0611-1. - PubMed
    1. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13(3):275–86. 10.1111/j.1467-789X.2011.00952.x. - PubMed
    1. Batista TM, Haider N, Kahn CR. Defining the underlying defect in insulin action in type 2 diabetes. Diabetologia. 2021;64(5):994–1006. 10.1007/s00125-021-05415-5. - PMC - PubMed
    1. Blasco-Baque V, Garidou L, Pomié C, Escoula Q, Loubieres P, Le Gall-David S, Lemaitre M, Nicolas S, Klopp P, Waget A, Azalbert V, Colom A, Bonnaure-Mallet M, Kemoun P, Serino M, Burcelin R. Periodontitis induced by Porphyromonas gingivalis drives periodontal microbiota dysbiosis and insulin resistance via an impaired adaptive immune response. Gut. 2017;66(5):872–85. 10.1136/gutjnl-2015-309897. - PMC - PubMed
    1. Borgnakke, W. S., Genco, R. J., Eke, P. I., & Taylor, G. W. (2018). Oral Health and Diabetes. In C. C. Cowie et al. (Eds.), Diabetes in America (3rd ed., pp. 24-1–24-20). National Institute of Diabetes and Digestive and Kidney Diseases (US). https://www.ncbi.nlm.nih.gov/books/NBK567979/. - PubMed

LinkOut - more resources