Periodontitis and pre-clinical diabetes

牙周炎和临床前糖尿病

• 批准号: 9085612
• 负责人: KAUMUDI J JOSHIPURA
• 金额: $ 12.79万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-15 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9085612
• 关键词: Adult; Age-Years; Blood; Blood Pressure; Body mass index; C-reactive protein; Clinical; Complex; Dental; Diabetes Mellitus; Disease Resistance; Dyslipidemias; Fasting; Fatty acid glycerol esters; Glucose; Glucose Intolerance; Goals; Healthcare; High Density Lipoprotein Cholesterol; High Prevalence; Hour; Hypertriglyceridemia; Incidence; Individual; Insulin Resistance; Interleukin-6; Interview; Longitudinal Studies; Low income; Measurement; Measures; Mediating; Minority; Morbidity - disease rate; Municipalities; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Obesity; Oral; Overweight; Participant; Pathway interactions; Periodontal Diseases; Periodontitis; Play; Population; Prevention; Public Health; Puerto Rican; Puerto Rico; Recruitment Activity; Risk Factors; Staging; Time; Tumor Necrosis Factor-alpha; Visit; adipokines; adiponectin; blood glucose regulation; cohort; design; follow-up; glucose tolerance; high risk; improved; inflammatory marker; modifiable risk; mortality; oral glucose tolerance; pre-clinical; prevent; waist circumference

DESCRIPTION (provided by applicant): Several studies have shown associations between periodontal disease and type 2 diabetes, but very little evidence is available from longitudinal studies. Hence, the relationships are complex and it is unclear whether periodontal disease is a cause or consequence of diabetes or both and it is important to establish the temporal sequence. As a first step to clearly establish the time sequence, this study focuses on assessing the impact of periodontal disease on the progression of preclinical stages of diabetes and the impact of preclinical stages of diabetes on progression of periodontal disease. This study is unique in establishing a cohort of overweight and obese individuals free of diabetes. This unique population will constitute a high risk group because of the high levels of periodontal disease and insulin resistance and expected higher rates of progression enabling an efficient design. The specific aims are: (1) to assess whether, over a three-year period, individuals with periodontal disease at baseline have a higher increase in glucose intolerance and insulin resistance compared to those without periodontal disease; (2) to determine if the longitudinal association between baseline periodontal disease and increases in glucose tolerance and insulin resistance is mediated through adipokines, dyslipidemia and/or inflammatory markers, including C reactive protein, tumor necrosis factor , and interleukin 6; (3) to assess whether baseline glucose abnormalities and insulin resistance are associated with progression of periodontal disease over a three-year interval; and (4) to assess the linear association between adiposity measures including body mass index, waist circumference and fat mass at baseline and periodontal disease. We plan to include a high-risk group of overweight or obese adults, 40-65 years of age, free of diabetes and of conditions that preclude a periodontal exam recruited from the San Juan municipality. Participants will be assessed at baseline and three years after the baseline exam. The baseline and follow-up visits will include blood drawing at fasting and 2 hour oral glucose tolerance test, blood pressure assessment, dental examinations, interviews and anthropometrics measures. We will evaluate the longitudinal relationship between clinical periodontal measures and changes over a three-year time period in oral glucose tolerance and insulin resistance. We will also assess the relationship of baseline anthropometric measurements, oral glucose and insulin resistance with the progression of periodontal disease. The long-term goals will be to continue follow-up to assess whether periodontal disease is a risk factor for the incidence of type 2 diabetes among participants with glucose intolerance and/or insulin resistance. Given the high prevalence of periodontal disease and type 2 diabetes, this study is highly significant as periodontal disease could be a modifiable risk factor for type 2 diabetes.

描述（由申请人提供）：几项研究表明牙周病和2型糖尿病之间存在关联，但纵向研究的证据很少。因此，关系是复杂的，目前还不清楚牙周病是糖尿病的原因或后果，或两者兼而有之，重要的是要建立时间顺序。作为明确建立时间顺序的第一步，本研究重点评估牙周病对糖尿病临床前阶段进展的影响以及糖尿病临床前阶段对牙周病进展的影响。这项研究在建立一个无糖尿病的超重和肥胖个体队列方面是独一无二的。由于牙周病和胰岛素抵抗的高水平以及预期更高的进展率，这一独特的人群将构成高风险人群，从而实现有效的设计。具体目标是：（1）评估在三年的时间内，基线时患有牙周病的个体与没有牙周病的个体相比，葡萄糖耐受不良和胰岛素抵抗是否有更高的增加;（2）确定基线牙周病与葡萄糖耐量和胰岛素抵抗增加之间的纵向关联是否通过脂肪因子、血脂异常和/或炎症标志物介导，包括C反应蛋白、肿瘤坏死因子和白细胞介素6;（3）评估基线血糖异常和胰岛素抵抗是否与三年内牙周病的进展有关;以及（4）评估肥胖测量（包括体重指数、腰围和基线脂肪量）与牙周病之间的线性关系。我们计划纳入一组超重或肥胖的高危人群，年龄在40-65岁之间，无糖尿病和排除从圣胡安市招募的牙周检查的条件。参与者将在基线和基线检查后三年进行评估，基线和随访访视包括空腹抽血和2小时口服葡萄糖耐量试验、血压评估、牙科检查、访谈和人体测量。我们将评估临床牙周测量与三年内口服葡萄糖耐量和胰岛素抵抗变化之间的纵向关系。我们还将评估基线人体测量、口服葡萄糖和胰岛素抵抗与牙周病进展的关系。长期目标是继续随访，以评估牙周病是否是葡萄糖耐受不良和/或胰岛素抵抗参与者中2型糖尿病发病率的危险因素。鉴于牙周病和2型糖尿病的高患病率，这项研究是非常重要的，因为牙周病可能是2型糖尿病的一个可改变的风险因素。

项目成果

Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures.

颈部周长可能是标准人体测量指标的更好替代方法。

• DOI: 10.1155/2016/6058916
• 发表时间: 2016
• 期刊: Journal of diabetes research
• 影响因子: 4.3
• 作者: Joshipura K;Muñoz-Torres F;Vergara J;Palacios C;Pérez CM
• 通讯作者: Pérez CM

Association between within-visit systolic blood pressure variability and development of pre-diabetes and diabetes among overweight/obese individuals.

• DOI: 10.1038/s41371-017-0009-y
• 发表时间: 2017-12
• 期刊: Journal of human hypertension
• 影响因子: 2.7
• 作者: Joshipura KJ;Muñoz-Torres FJ;Campos M;Rivera-Díaz AD;Zevallos JC
• 通讯作者: Zevallos JC

Comparing glucose and hemoglobin A1c diagnostic tests among a high metabolic risk Hispanic population.

比较高代谢风险西班牙裔人群的葡萄糖和糖化血红蛋白诊断测试。

• DOI: 10.1002/dmrr.2874
• 发表时间: 2017
• 期刊: Diabetes/metabolism research and reviews
• 作者: Vega-Vázquez,MónicaA;Ramírez-Vick,Margarita;Muñoz-Torres,FranciscoJ;González-Rodríguez,LoidaA;Joshipura,Kaumudi
• 通讯作者: Joshipura,Kaumudi