{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:51:08Z","timestamp":1792525868227,"version":"4.5.0"},"reference-count":27,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,7,1]]},"abstract":"<jats:p>OBJECTIVE\u2014Type 2 diabetes and periodontal disease are known to be associated, but the temporality of this relationship has not been firmly established. We investigated whether baseline periodontal disease independently predicts incident diabetes over two decades of follow-up.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014A total of 9,296 nondiabetic male and female National Health and Nutrition Examination Survey (NHANES I) participants aged 25\u201374 years who completed a baseline dental examination (1971\u20131976) and had at least one follow-up evaluation (1982\u20131992) were studied. We defined six categories of baseline periodontal disease using the periodontal index. Of 7,168 dentate participants, 47% had periodontal index = 0 (periodontally healthy); the remaining were classified into periodontal index quintiles. Incident diabetes was defined by 1) death certificate (ICD-9 code 250), 2) self-report of diabetes requiring pharmacological treatment, or 3) health care facility stay with diabetes discharge code. Multivariable logistic regression models assessed incident diabetes odds across increasing levels of periodontal index in comparison with periodontally healthy participants.<\/jats:p>\n               <jats:p>RESULTS\u2014The adjusted odds ratios (ORs) for incident diabetes in periodontal index categories 1 and 2 were not elevated, whereas the ORs in periodontal index categories 3 through 5 were 2.26 (95% CI 1.56\u20133.27), 1.71 (1.0\u20132.69), and 1.50 (0.99\u20132.27), respectively. The OR in edentulous participants was 1.30 (1.00\u20131.70). Dentate participants with advanced tooth loss had an OR of 1.70 (P &amp;lt; 0.05) relative to those with minimal tooth loss.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Baseline periodontal disease is an independent predictor of incident diabetes in the nationally representative sample of NHANES I.<\/jats:p>","DOI":"10.2337\/dc08-0026","type":"journal-article","created":{"date-parts":[[2008,6,7]],"date-time":"2008-06-07T00:49:14Z","timestamp":1212799754000},"page":"1373-1379","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":286,"title":["Periodontal Disease and Incident Type 2 Diabetes"],"prefix":"10.2337","volume":"31","author":[{"given":"Ryan T.","family":"Demmer","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, and the Department of Nutrition, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moi\u0308se","family":"Desvarieux","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"},{"name":"Institut National de la Sante\u0301 et de la Recherche Me\u0301dicale and Unite\u0301 Mixte de Recherche S707, Universite Pierre et Marie Curie-Paris6, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031302081459500_R1","doi-asserted-by":"crossref","unstructured":"Taylor GW: Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol\u20086: 99\u2013112, 2001","DOI":"10.1902\/annals.2001.6.1.99"},{"key":"2022031302081459500_R2","unstructured":"Hein C, Cobb C, Iacopino A: Report of the Independent Panel of Experts of The Scottsdale Project. Grand Rounds Oral Syst Med\u20082 (Suppl.):1\u201327, 2007"},{"key":"2022031302081459500_R3","doi-asserted-by":"crossref","unstructured":"Loe H: Periodontal disease: the sixth complication of diabetes mellitus. Diabetes Care\u200816:329\u2013334, 1993","DOI":"10.2337\/diacare.16.1.329"},{"key":"2022031302081459500_R4","doi-asserted-by":"crossref","unstructured":"Wu T, Trevisan M, Genco RJ, Dorn JP, Falkner KL, Sempos CT: Periodontal disease and risk of cerebrovascular disease: the First National Health and Nutrition Examination Survey and its Follow-up Study. Arch Intern Med\u2008160:2749\u20132755, 2000","DOI":"10.1001\/archinte.160.18.2749"},{"key":"2022031302081459500_R5","doi-asserted-by":"crossref","unstructured":"DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM: Dental disease and risk of coronary heart disease and mortality. BMJ\u2008306:688\u2013691, 1993","DOI":"10.1136\/bmj.306.6879.688"},{"key":"2022031302081459500_R6","doi-asserted-by":"crossref","unstructured":"Demmer RT, Desvarieux M: Periodontal infections and cardiovascular disease: The heart of the matter. J Am Dent Assoc\u2008137 (Suppl.):14S\u201320S, 2006","DOI":"10.14219\/jada.archive.2006.0402"},{"key":"2022031302081459500_R7","doi-asserted-by":"crossref","unstructured":"Beck JD, Eke P, Lin D, Madianos P, Couper D, Moss K, Elter J, Heiss G, Offenbacher S: Associations between IgG antibody to oral organisms and carotid intima-medial thickness in community-dwelling adults. Atherosclerosis\u2008183:342\u2013348, 2005","DOI":"10.1016\/j.atherosclerosis.2005.03.017"},{"key":"2022031302081459500_R8","doi-asserted-by":"crossref","unstructured":"Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC, Sowers JR: Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation\u2008100:1134\u20131146, 1999","DOI":"10.1161\/01.CIR.100.10.1134"},{"key":"2022031302081459500_R9","doi-asserted-by":"crossref","unstructured":"Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA\u2008286:327\u2013334, 2001","DOI":"10.1001\/jama.286.3.327"},{"key":"2022031302081459500_R10","doi-asserted-by":"crossref","unstructured":"Hu FB, Meigs JB, Li TY, Rifai N, Manson JE: Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes\u200853:693\u2013700, 2004","DOI":"10.2337\/diabetes.53.3.693"},{"key":"2022031302081459500_R11","doi-asserted-by":"crossref","unstructured":"Papapanou PN, Sedaghatfar MH, Demmer RT, Wolf DL, Yang J, Roth GA, Celenti R, Belusko PB, Lalla E, Pavlidis P: Periodontal therapy alters gene expression of peripheral blood monocytes. J Clin Periodontol\u200834:736\u2013747, 2007","DOI":"10.1111\/j.1600-051X.2007.01113.x"},{"key":"2022031302081459500_R12","doi-asserted-by":"crossref","unstructured":"Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J: Treatment of periodontitis and endothelial function. N Engl J Med\u2008356:911\u2013920, 2007","DOI":"10.1056\/NEJMoa063186"},{"key":"2022031302081459500_R13","unstructured":"National Center for Health Statistics: Plan and Operation of the Health and Nutrition Examination Survey: United States 1971\u20131973. Washington, DC, U.S. Govt. Printing Office, 1973 (DHEW Publ. No. (PHS) 79-1310)"},{"key":"2022031302081459500_R14","unstructured":"Kelly JE, Harvey CR: Basic data on dental examination findings of persons 1\u201374 years: United States, 1971\u20131974. Vital Health Stat\u200811\u20081\u201333, 1979"},{"key":"2022031302081459500_R15","doi-asserted-by":"crossref","unstructured":"Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA: Periodontal disease and coronary heart disease risk. JAMA\u2008284:1406\u20131410, 2000","DOI":"10.1001\/jama.284.11.1406"},{"key":"2022031302081459500_R16","doi-asserted-by":"crossref","unstructured":"Machlin SR, Kleinman JC, Madans JH: Validity of mortality analysis based on retrospective smoking information. Stat Med\u20088:997\u20131009, 1989","DOI":"10.1002\/sim.4780080810"},{"key":"2022031302081459500_R17","doi-asserted-by":"crossref","unstructured":"Pihlstrom BL, Michalowicz BS, Johnson NW: Periodontal diseases. Lancet\u2008366:1809\u20131820, 2005","DOI":"10.1016\/S0140-6736(05)67728-8"},{"key":"2022031302081459500_R18","doi-asserted-by":"crossref","unstructured":"Lipton RB, Liao Y, Cao G, Cooper RS, McGee D: Determinants of incident non-insulin-dependent diabetes mellitus among blacks and whites in a national sample: the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol\u2008138:826\u2013839, 1993","DOI":"10.1093\/oxfordjournals.aje.a116786"},{"key":"2022031302081459500_R19","unstructured":"Demmer, RT: Infections and Systemic Disease: Methodological Issues for Periodontal Infection Models; Application to Type 2 Diabetes Mellitus Risk Factor Epidemiology. ProQuest Digital Dissertations Publication Number: AAT 3198088. Minneapolis, University of Minnesota, 2005"},{"key":"2022031302081459500_R20","doi-asserted-by":"crossref","unstructured":"Beck JD, Offenbacher S: Relationships among clinical measures of periodontal disease and their associations with systemic markers. Ann Periodontol\u20087:79\u201389, 2002","DOI":"10.1902\/annals.2002.7.1.79"},{"key":"2022031302081459500_R21","doi-asserted-by":"crossref","unstructured":"Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DR, Papapanou PN, Sacco RL: Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke\u200834:2120\u20132125, 2003","DOI":"10.1161\/01.STR.0000085086.50957.22"},{"key":"2022031302081459500_R22","doi-asserted-by":"crossref","unstructured":"Thorand B, Baumert J, Kolb H, Meisinger C, Chambless L, Koenig W, Herder C: Sex differences in the prediction of type 2 diabetes by inflammatory markers: results from the MONICA\/KORA Augsburg case-cohort study, 1984\u20132002. Diabetes Care\u200830:854\u2013860, 2007","DOI":"10.2337\/dc06-1693"},{"key":"2022031302081459500_R23","doi-asserted-by":"crossref","unstructured":"Desvarieux M, Schwahn C, Volzke H, Demmer RT, Ludemann J, Kessler C, Jacobs DR, John U, Kocher T: Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis. Stroke\u200835:2029\u20132035, 2004","DOI":"10.1161\/01.STR.0000136767.71518.36"},{"key":"2022031302081459500_R24","doi-asserted-by":"crossref","unstructured":"Harris MI, Hadden WC, Knowler WC, Bennett PH: Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20\u201374 yr. Diabetes\u200836:523\u2013534, 1987","DOI":"10.2337\/diab.36.4.523"},{"key":"2022031302081459500_R25","doi-asserted-by":"crossref","unstructured":"Borrell LN, Kunzel C, Lamster I, Lalla E: Diabetes in the dental office: using NHANES III to estimate the probability of undiagnosed disease. J Periodontal Res\u200842:559\u2013565, 2007","DOI":"10.1111\/j.1600-0765.2007.00983.x"},{"key":"2022031302081459500_R26","doi-asserted-by":"crossref","unstructured":"Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DR, Sacco RL, Papapanou PN: Periodontal microbiota and carotid intima-media thickness: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Circulation\u2008111:576\u2013582, 2005","DOI":"10.1161\/01.CIR.0000154582.37101.15"},{"key":"2022031302081459500_R27","doi-asserted-by":"crossref","unstructured":"Papapanou PN: Periodontal diseases: epidemiology. Ann Periodontol\u20081:1\u201336,1996","DOI":"10.1902\/annals.1996.1.1.1"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/31\/7\/1373\/599407\/zdc00708001373.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/31\/7\/1373\/599407\/zdc00708001373.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T06:16:05Z","timestamp":1647152165000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/31\/7\/1373\/39079\/Periodontal-Disease-and-Incident-Type-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,1]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,7,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc08-0026","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,1]]}}}