Insulin resistance predicts the risk of gingival/periodontal inflammation

Oelisoa M. Andriankaja, Francisco J. Muñoz-Torres, José Vivaldi-Oliver, Brian G. Leroux, Maribel Campos, Kaumudi Joshipura, Cynthia M. Pérez

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives: Evaluate whether insulin resistance (IR) predicts the risk of oral inflammation, assessed as the number of sites with bleeding on probing (BOP) and number of teeth with probing pocket depths (PPD) ≥ 4 mm and BOP. Methods: Data on 870 overweight/obese diabetes free adults, aged 40–65 years from the San Juan Overweight Adults Longitudinal Study over a three-year period, was analyzed. Baseline IR, assessed using the Homeostasis Model Assessment of IR (HOMA-IR) index, was divided into tertiles. BOP was assessed at buccal and lingual sites, and PPD at six sites per tooth. Negative binomial regression was used to estimate the risk ratios (RRs) for oral inflammation adjusted for baseline age, gender, smoking status, alcohol intake, education, physical activity, waist circumference, mean plaque index, and baseline number of sites with BOP, or number of teeth with PPD≥4 mm and BOP. The potential impact of tertiles of serum TNF-α and adiponectin on the IR-oral inflammation association was also assessed in a subsample of 597 participants. Results: Participants in the highest HOMA-IR tertile at baseline had significantly higher numbers of sites with BOP [RR = 1.19, 95% confidence interval (CI): 1.03–1.36] and number of teeth with PPD ≥ 4 mm and BOP (RR = 1.39, 95% CI: 1.09–1.78) at follow-up, compared with individuals in the lower two HOMA-IR tertiles. Neither TNF-α nor adiponectin confounded the associations. Conclusion: IR significantly predicts gingival/periodontal inflammation in this population.

Original languageEnglish
Pages (from-to)549-557
Number of pages9
JournalJournal of Periodontology
Issue number5
StatePublished - May 2018

Bibliographical note

Funding Information:
This work was fully supported by Award Number R01DE020111 from the National Institute of Dental and Craniofacial Research (NIDCR) and partially supported by award number 2U54MD007587 from the National Institute on Minority Health and Health Disparities (NIMHD), award number 1U54RR026139-01A1 from the National Center for Research Resources (NCRR), and award Number K23 DE025313-01 from the National Institute of Dental and Craniofacial Research (NIDCR). The authors acknowledge the SOALS team (Tania Ginebra, Carla León, Yashira Maldonado, Dr. Sasha Martínez, Xiomara O'Farrill, Saman-tha Ordaz, Dr. Margarita Ramírez-Vick, Elaine Rodríguez, Rosalyn Román, Rafael Ruiz, Yadiris Santaella, Grace Vélez, José L. Vergara, Lay Wah, Jeanpaul Fernández) and PRCTRC laboratory personnel (Aracelis Arroyo and Nilda González) who contributed to the conduct/oversight/planning of data collection of the study.

Publisher Copyright:
© 2018 American Academy of Periodontology


  • gingivitis
  • inflammation
  • insulin resistance
  • obesity
  • periodontitis
  • prospective studies
  • type 2 diabetes

ASJC Scopus subject areas

  • Periodontics


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