Association Between Periodontal Status and Undiagnosed Diabetes in Adults Without Diagnosed Chronic Diseases: The Korea National Health and Nutrition Examination Survey 2013-2015.

Abstract

Background/Objectives: Periodontitis and diabetes are closely linked; however, whether periodontal findings are associated with previously unrecognized dysglycemia in adults without known chronic diseases remains unclear. We examined the association between periodontal status and undiagnosed prediabetes and diabetes in this population. Methods: We analyzed data from 7635 adults (3218 men and 4417 women) aged ≥19 years without self-reported physician-diagnosed chronic diseases who participated in the Korea National Health and Nutrition Examination Survey 2013-2015. Glycemic status was classified as normal, undiagnosed prediabetes, or undiagnosed diabetes based on a single measurement of fasting plasma glucose and glycated hemoglobin. Periodontal status was determined with the Community Periodontal Index (CPI) and grouped as CPI 0-2, CPI 3, or CPI 4. Survey-weighted multivariable logistic regression analyses were performed in men and women separately, and effect modification by sex was formally tested. Results: Undiagnosed prediabetes and diabetes were present in 42.0% and 5.0% of men and in 31.7% and 2.9% of women (weighted estimates). After multivariable adjustment, CPI 3 (odds ratio [OR] 3.594, 95% confidence interval [CI] 1.553-8.316) and CPI 4 (OR 5.837, 95% CI 2.341-14.555) were associated with higher odds of undiagnosed diabetes in men, whereas no significant association was observed in women (p for sex interaction = 0.004). Periodontal status was not associated with undiagnosed prediabetes in either sex. Conclusions: In this cross-sectional analysis, CPI-defined periodontitis was associated with higher odds of undiagnosed diabetes in men. These findings do not establish causality or the diagnostic performance of periodontal examination as a screening test; rather, periodontal findings may help identify individuals in whom standard diabetes risk assessment or medical referral could be considered.