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

Oelisoa M. Andriankaja; Kaumudi J. Joshipura; Michael A. Levine; Margarita Ramirez-Vick; Julio A. Rivas-Agosto; Jorge S. Duconge; Dana T. Graves

doi:10.1177/20406223231213252

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

Oelisoa M. Andriankaja
, Kaumudi J. Joshipura
, Michael A. Levine
, Margarita Ramirez-Vick
, Julio A. Rivas-Agosto
, Jorge S. Duconge
, Dana T. Graves

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

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.

Original language	English
Journal	Therapeutic Advances in Chronic Disease
Volume	14
DOIs	https://doi.org/10.1177/20406223231213252
State	Published - Jan 1 2023

Bibliographical note

Publisher Copyright:
© The Author(s), 2023.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the grant award K23 DE025313 (OMA) and R01 DE026603 (DTG) from the National Institute of Dental and Craniofacial Research, and # U54GM113807-01A-1 from the NIH, which funded the Hispanic Alliance for Clinical and Translational Research (former Puerto Rico Clinical and Translational Research Consortium, PRCTRC). The authors also acknowledge the LLIPDS team (Dr. Francisco Jiménez, Mr. Francisco Muñoz-Torres, Mr. Abdiel Castillo, Ms. Claudia Díaz, Mr. Alexis Acevedo, Ms. Patricia Serrano, Mr. Alejandro Llera, and all who participated in the study) the Alliance (formerly PRCTRC) personnel, who contributed to the conduct/oversight/planning of data collection of the study (administrative and regulatory affairs: Ms. Antonia Ortiz, Ms. Ivette Molina, and Ms. Adelma Rivera; nurses: Ms. Bárbara Guzmán, Ms. Sheyla Garced, Ms. Ladimila De Lima, and Mr. Robert Pinder; laboratory work: Mrs. Nilda González and Ms. Carola López-Cepero), and Dr. Hatice Hasturk, Director of the Center for Clinical and Translational Research at the Forsyth Institute, who provided the training and calibration of the dental examiner. The authors also acknowledge the Puerto Rico Diabetes Center, COSSMA, and all participants, who contributed to and participated in the study, and Dr. Yan Huang at the Medical University of South Carolina, College of Medicine for his additional help in the data interpretation. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the grant award K23 DE025313 (OMA) and R01 DE026603 (DTG) from the National Institute of Dental and Craniofacial Research, and # U54GM113807-01A-1 from the NIH, which funded the Hispanic Alliance for Clinical and Translational Research (former Puerto Rico Clinical and Translational Research Consortium, PRCTRC).

Funders	Funder number
Dr. Hatice Hasturk
Forsyth Institute
Puerto Rico Clinical and Translational Research Consortium
Puerto Rico Diabetes Center
National Institutes of Health (NIH)
National Institute of Dental and Craniofacial Research	U54GM113807-01A-1
Medical University South Carolina	K23 DE025313, R01 DE026603
Center for Clinical and Translational Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

chronic periodontitis
cross-sectional study
hypolipidemic agents
statins
tooth loss
type 2 diabetes mellitus

ASJC Scopus subject areas

Medicine (miscellaneous)

Access to Document

10.1177/20406223231213252

Cite this

@article{0b16727053d9425b83ac46e659726af1,

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

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.",

keywords = "chronic periodontitis, cross-sectional study, hypolipidemic agents, statins, tooth loss, type 2 diabetes mellitus",

author = "Andriankaja, \{Oelisoa M.\} and Joshipura, \{Kaumudi J.\} and Levine, \{Michael A.\} and Margarita Ramirez-Vick and Rivas-Agosto, \{Julio A.\} and Duconge, \{Jorge S.\} and Graves, \{Dana T.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2023.",

year = "2023",

month = jan,

day = "1",

doi = "10.1177/20406223231213252",

language = "English",

volume = "14",

}

TY - JOUR

T1 - Hispanic adults with type 2 diabetes mellitus using lipid-lowering agents have better periodontal health than non-users

AU - Andriankaja, Oelisoa M.

AU - Joshipura, Kaumudi J.

AU - Levine, Michael A.

AU - Ramirez-Vick, Margarita

AU - Rivas-Agosto, Julio A.

AU - Duconge, Jorge S.

AU - Graves, Dana T.

PY - 2023/1/1

Y1 - 2023/1/1

N2 - 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.

AB - 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.

KW - chronic periodontitis

KW - cross-sectional study

KW - hypolipidemic agents

KW - statins

KW - tooth loss

KW - type 2 diabetes mellitus

UR - https://www.scopus.com/pages/publications/85181728603

UR - https://www.scopus.com/pages/publications/85181728603#tab=citedBy

U2 - 10.1177/20406223231213252

DO - 10.1177/20406223231213252

M3 - Article

AN - SCOPUS:85181728603

SN - 2040-6223

VL - 14

JO - Therapeutic Advances in Chronic Disease

JF - Therapeutic Advances in Chronic Disease

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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