Association between periodontitis and the Mediterranean diet in young Moroccan individuals.

BACKGROUND & OBJECTIVES: Adherence to the Mediterranean diet (MedDiet) has been reported to be associated with a lower risk of various chronic diseases. This cross-sectional study aimed to investigate the potential association between adherence to the MedDiet and periodontitis, which is highly prevalent in young Moroccan individuals. METHODS: We evaluated 1075 Moroccan individuals (72% women, mean [standard deviation] age = 20.2 [1.5] years). Adherence to the MedDiet was assessed using the MedDiet score (MDS) based on the frequency of intake of eight food groups (vegetables, legumes, fruits, cereals or potatoes, fish, red meat, dairy products, and olive oil). A value of 0 (unhealthy) or 1 (healthy) was assigned to each food group, and the MDS (range, 0-8 points) was generated by adding the individual scores, with a higher score indicating better adherence to the MedDiet. The logistic regression model was used to evaluate the MDS (high [5-8 points]/low [0-4 points]) and each component score (1/0) with the presence of periodontitis, which was determined through full-mouth periodontal examinations. Age, sex, and oral health behavior were considered as potential confounders. RESULTS: In total, 693 (64.5%) study participants showed high MDSs. Periodontitis was observed in 71 (6.6%) participants. No significant association between MDS and periodontitis was observed. Nonetheless, olive oil consumption, a component of the MDS, showed a significant inverse association with periodontitis (adjusted odds ratio = 0.55; 95% confidence interval, 0.32-0.96). CONCLUSIONS: The MedDiet was not significantly associated with periodontitis among young Moroccans. However, frequent consumption of olive oil may have a protective effect against periodontitis, although the temporal association needs to be clarified in further studies.

A multilevel analysis of the importance of oral health instructions for preventing tooth loss: The 8020 Promotion Foundation Study of Japanese Dental Patients.

BACKGROUND: Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss. METHODS: Baseline surveys were conducted at 1216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels. RESULTS: Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50-0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50-0.96). CONCLUSIONS: In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.

Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5-year cohort study.

BACKGROUND AND OBJECTIVES: Identification of modifiable factors for mild cognitive impairment (MCI) is important since individuals with MCI are at a high risk of dementia and disability. Previous studies have suggested a potential association between periodontitis and cognitive impairment, but the results remain inconclusive. We designed a 5-year longitudinal study to explore the association between MCI and periodontitis and periodontal inflammation in older adults. METHODS: This study included 179 community-dwelling dentate individuals (62 men and 117 women, average age: 80.1 years). A full-mouth periodontal examination at six sites per tooth was performed at baseline. Case definitions provided by the European Workshop in Periodontology Group C (EWP definition) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP definition) were used to define severe periodontitis. Additionally, the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated using clinical periodontal parameters. Follow-up cognitive examinations for MCI diagnosis were performed by neurologists 1, 2, 3, and 5 years after baseline. Odds ratios (ORs) for MCI according to the presence of periodontitis and periodontal inflammation at baseline were calculated using multilevel mixed-effects logistic regression. RESULTS: At baseline, 56.4% and 27.4% of the participants had severe periodontitis by the EWP and CDC/AAP definitions, respectively. After adjusting for follow-up period and other baseline health characteristics (age, sex, smoking status, educational level, physical activity level, obesity, depression, and diabetes), severe periodontitis by either definition was significantly associated with MCI (for the EWP definition: adjusted OR = 3.58, 95% confidence interval [CI] = 1.45-8.87; for the CDC/AAP definition: adjusted OR = 2.61, 95% CI = 1.08-6.28). Periodontal inflammation assessed by PISA was also significantly associated with a higher OR for MCI (adjusted OR = 1.05, 95% CI = 1.01-1.10, per 10-mm2 increase in PISA). CONCLUSION: Severe periodontitis and periodontal inflammation were associated with incident MCI among older community-dwelling men and women.

Influence of occlusal deterioration considering prosthetics on subsequent all-cause mortality in a Japanese elderly independent population.

PURPOSE: The influence of occlusal deterioration on mortality may be incorrectly estimated due to improvements in the occlusal condition with prosthetics or deterioration without prosthetics. The purpose of this study was to evaluate the influence of occlusion cross-sectional status and longitudinal changes considering prosthetics for subsequent all-cause mortality in an elderly population. METHODS: Two dental examinations, in 1999 and 2003, were conducted in 378 subjects aged 71 years old in 1999. Annual follow-ups to check survival information were performed until 2011. The Eichner index (EI), based on tooth contacts between the maxilla and mandible in the bilateral molar regions, was used as a measurement of occlusal condition. Three modified EIs, EI-o (ie, original EI), EI-f adding contacts by fixed prosthetic appliances, and EI-r adding contacts by all prosthetics, were used. For survival analysis, the survival period was calculated from the last dental examination (in 2003) to death or censoring. RESULTS: In Cox proportional hazards regression analysis, a deterioration in EI-f was a significant risk factor for stability (HR = 2.56, P = 0.018) after adjusting for potential confounders. However, occlusal conditions in 2003 did not have an influence on subsequent mortality and the occlusal losses of almost all subjects were at least partially recovered by removable prosthetics. CONCLUSION: This study clarified that prosthetic dental care may reduce the influence of occlusal loss on mortality and that an event such as a large occlusal loss unrecoverable with fixed prosthesis alone at an older age may increase risk of death in Japanese elderly subjects.

Relationship between clinical periodontal parameters and changes in liver enzymes levels over an 8-year period in an elderly Japanese population.

AIMS: An association between periodontal disease and liver enzymes has been reported previously. This study examined the relationship between clinical periodontal parameters and changes in liver enzymes levels in 265 non-institutionalized Japanese elderly aged 72 years over 8 years. MATERIALS AND METHODS: The number of sites with probing pocket depth (PPD) ≥ 6 mm and clinical attachment level (CAL) ≥ 6 mm were measured. Changes in liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]) was grouped based on any elevation of concentrations. The relationship was determined by logistic regression with adjustment for confounders. Interaction test and stratified analysis were then performed according to smoking status and alcohol drinking habits, separately. RESULTS: Elevation in ALT, but not AST, was significantly associated with PPD (odds ratio [OR] = 1.10) and CAL (OR = 1.03). A significant interaction of periodontal parameters on ALT was observed with smoking status, but not with alcohol drinking habit. The stratified analysis suggested that ALT was found to be significantly correlated with PPD (OR = 1.20) and CAL (OR = 1.04) to those who were smoker. CONCLUSION: The elevation in ALT levels might be associated with clinical periodontal parameters among non-institutionalized Japanese elderly, and this association was modified by smoking status.

Relationship between vitamin D receptor gene polymorphism and susceptibility to chronic kidney disease and periodontal disease in community-dwelling elderly.

OBJECTIVES: The aim of this study was to investigate the possible correlation between vitamin D receptor (VDR) gene polymorphism and susceptibility to chronic kidney disease (CKD) and periodontal disease. MATERIAL AND METHODS: This study analysed 345 participants, who were all 79 years of age. Kidney function levels were determined based on the estimated glomerular filtration rate (eGFR; non-reduced function: ≥60 and reduced function: <60 ml min-1  1.73 m-2 ). VDR TaqI genotyping was also studied. We calculated the periodontal inflamed surface area (PISA). After classifying participants into quartile groups according to eGFR or PISA values, the subjects were then split into two groups (highest quartile versus the other three groups combined). Multiple logistic regression analysis was performed to evaluate the odds ratios between the eGFR and VDR TaqI genotype with the different PISA groups. The eGFR was set as the dependent variable while the VDR TaqI genotype, HbA1C, gender, smoking habits and body mass index were defined as independent variables. RESULTS: A significant association was observed between the VDR TaqI genotype and eGFR in the PISA high group (odds ratio = 3.97, p = .027). CONCLUSION: Study results suggest that VDR TaqI genotype might be associated with CKD during inflammatory conditions caused by periodontal disease.

Effect of lifestyle on 6-year periodontitis incidence or progression and tooth loss in older adults.

AIM: To evaluate the longitudinal association of combined healthy lifestyle factors with incidence or progression of periodontitis and tooth loss in older adults. MATERIALS AND METHODS: This 6-year study included 374 Japanese 70-year olds with 7,157 teeth, from a source eligible baseline population of 554 individuals. Four lifestyle factors-cigarette smoking, physical activity, relative weight, and dietary quality-were scored as healthy (1 point) or unhealthy (0 point). Adding the individual scores generated the "healthy lifestyle score" (0-4 points). Multilevel mixed-effects logistic regression models were applied to evaluate tooth-specific associations between the baseline healthy lifestyle score and the incidence or progression of periodontitis (increase in clinical attachment loss ≥3 mm) and tooth loss. RESULTS: After 6 years, 19.0% of the teeth exhibited periodontitis incidence or progression and 8.2% were lost. Compared with a healthy lifestyle score of 0-1 (least healthy), the highest score (4 points) was associated with a significantly lower tooth-specific risk of periodontitis (adjusted odds ratio = 0.32; 95% confidence interval: 0.16-0.62) and tooth loss (adjusted odds ratio = 0.42; 95% confidence interval: 0.23-0.77). CONCLUSIONS: Simultaneous adherence to multiple healthy lifestyle factors significantly lowers the risk of incidence or progression of periodontitis and tooth loss in older adults.

Relationship between autoantibody associated with rheumatoid arthritis and tooth loss.

INTRODUCTION: This study evaluated the relationship between serum Rheumatoid Factor (RF) levels and tooth loss in a community-dwelling elderly Japanese women. It was hypothesised that women with high baseline RF levels would experience greater tooth loss over 10 years than age-matched women with lower baseline serum RF levels. MATERIALS AND METHODS: The study population consisted of 197 women aged 70 years with ≥12 teeth at baseline. One hundred and twenty-four participants completed a 10-year follow-up and were divided into 2 groups according to their baseline serum RF levels as follows: RF negative (<15 U/mL; n = 114) and RF positive (>15 U/mL; n = 10). Negative binomial regression was used to investigate the relationship between baseline RFs and tooth lost over the 10-year period. RF and its interaction with the baseline number of teeth were independent variables, with 9 other adjustment covariates. RESULTS: Baseline RFs were significantly associated with tooth loss (P = .035). In addition, a statistical interaction between baseline RFs and baseline number of teeth was identified (P = .023), modifying the association between RFs and tooth loss. The adjusted incidence rate ratio (IRR) for RF-positive participants with 21 baseline teeth was 1.88 (95% confidence interval (95% CI): 0.76, 4.65). IRRs obtained for participants who had 25 baseline teeth (3.02; 95% CI: 1.03, 8.83) or 30 baseline teeth (5.47; 95% CI: 1.29, 23.13) suggested that RF-positive participants with a high number of baseline teeth would exhibit greater tooth loss than RF-negative participants. CONCLUSION: High serum RF levels were associated with a greater IRR for future tooth loss in elderly Japanese women.

Relationship between alcohol consumption and periodontal tissue condition in community-dwelling elderly Japanese.

OBJECTIVES: To examine the associations among alcohol consumption level, dietary intake and other lifestyle factors, and periodontal condition, in community-dwelling elderly Japanese of a specific age. BACKGROUND: The relationship between alcohol consumption level and periodontitis is a controversial issue. METHODS: Participants were 438 dentate elders aged 73 years from a larger cohort survey of elders in Niigata City, Japan. Data collected from oral examination of each participant, including number of the existing teeth, mean probing pocket depth and mean clinical attachment level (CAL) were used for the analyses. A semiquantitative food frequency questionnaire and a lifestyle habit questionnaire were used to assess food and alcohol consumption, smoking experience, frequency of tooth brushing, interdental brush use, and visits to a dental clinic during the previous year. Blood glucose control was assessed by the glycated haemoglobin (HbA1c) level. Body mass index was calculated from height and weight measurements. The relationships between each variable and the individual mean CAL were analysed by univariate and multivariate analyses. RESULTS: According to logistic regression analysis, the mean CAL was significantly associated with the number of existing teeth (odds ratio [OR] = 0.90; P < .001), being a heavy drinker (OR = 2.44; P < .05), and smoking experience (OR = 2.37; P < .01). CONCLUSION: This study showed that increased mean CAL was significantly associated with heavy drinking in community-dwelling elderly Japanese (aged 73 years) compared with non-drinking. Our results provide new evidence that high alcohol consumption is associated with an increased risk of periodontal disease and its progression.

Hyposalivation and 10-year all-cause mortality in an elderly Japanese population.

OBJECTIVE: To evaluate the association of salivary flow rate with all-cause mortality among older Japanese adults. We hypothesised that hyposalivation would be a marker for mortality. BACKGROUND: Hyposalivation, which is an objectively measurable decrease in salivary flow, is highly prevalent among older adults. It is associated with malnutrition and poor general health. METHODS: The study population comprised 600 community-dwelling Japanese adults (306 men and 294 women), who were 70 years old at baseline. They underwent stimulated salivary flow rate (SSFR) measurements and were followed up during a 10-year study period. After stratification by sex, the hazard ratios of all-cause mortality were estimated using Cox proportional hazards regression analysis comparing groups with and without hyposalivation (ie, SSFR < 0.7 mL/min). RESULTS: The baseline prevalence of hyposalivation was 27.8% (85/306) among men and 47.3% (139/294) among women. During a mean (standard deviation) follow-up period of 104 (27) months, 80 deaths occurred: 60 (75.0%) deaths among men and 20 (25.0%) deaths among women. After adjusting for the number of remaining teeth, smoking status, exercise, hypoalbuminemia, diabetes and cardiovascular disease, hyposalivation at baseline was significantly associated with all-cause mortality among men (adjusted hazard ratio, 1.71; 95% confidence interval, 1.01-2.89). In contrast, no association between SSFR and all-cause mortality existed among women. CONCLUSION: Hyposalivation could be a marker for all-cause mortality among older community-dwelling Japanese men. Future studies investigating the association between SSFR and cause-specific mortality are warranted.

Relationship between renal function and periodontal disease in community-dwelling elderly women with different genotypes.

OBJECTIVES: The aim of this study was to examine the association between periodontal disease and renal function in elderly women with different genotypes. MATERIAL AND METHODS: A total of 332 postmenopausal never-smoking women were analysed. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers such as periodontal inflamed surface area (PISA) were evaluated. Selected variables, including PISA quartile, body mass index (BMI), HbA1C and age in Arg allele carriers and non-carriers based on the beta-3 adrenergic receptor, or between Ala allele carriers and non-carriers based on peroxisome proliferator-activated receptor gamma, were analysed using multiple logistic regression analysis. RESULTS: The odds ratios of serum cystatin C level and PISA (fourth quartile) were significantly positive for both Arg (2.52; p = 0.035) and Ala allele non-carriers (2.36; p = 0.021). A significant association was also found between serum cystatin C level and BMI for both Arg (1.18; p = 0.001) and Ala allele non-carriers (1.12; p = 0.003). CONCLUSION: The results of this study suggest that periodontal inflammation might be associated with renal function. Furthermore, in both the Arg and Ala allele non-carriers, the associations between BMI and PISA for renal function became stronger.

Bidirectional relationship between renal function and periodontal disease in older Japanese women.

OBJECTIVES: The purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease. MATERIAL AND METHODS: A total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels. RESULTS: On logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p = 0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level ≥6 mm was significantly positive (3.12, p < 0.001). Similar tendencies were shown for serum osteocalcin level. CONCLUSION: This study suggests that CKD and periodontal disease can have reciprocal effects.

Oral health and depression in older Japanese people.

OBJECTIVE: The aim of this study was to investigate the relationship between oral dysfunction and depressive symptoms in Japanese community-dwelling seniors. MATERIALS AND METHODS: Participants included 351 community-dwelling seniors (189 men, 162 women) aged 77 years. During dental examination, teeth and periodontal condition, including number of teeth, number of dental caries, pocket depth and clinical attachment level, were assessed, and unstimulated and stimulated salivary flow rates were measured. The General Health Questionnaire 30 (GHQ-30) was used to assess depression. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living. RESULTS: Multiple logistic regression analysis revealed that gender (odds ratio [OR] = 2.3), low unstimulated salivary flow rate (OR = 2.1), 'Complaint of mouth pain' (OR = 2.4), 'Complaint of physical disorders' (OR = 2.1), and the total TMIG Index of Competence score (OR = 2.0) were positively associated with the high GHQ-30 score. CONCLUSION: Subjective and objective oral dryness and oral pain are associated with depressive symptoms.

Cystatin C-based estimated glomerular filtration rate and periodontitis.

BACKGROUND AND OBJECTIVE: Accumulating evidence suggests that decreased kidney function characterised by low estimated glomerular filtration rate (eGFR) may be associated with periodontitis. Recent studies have suggested that the use of cystatin C strengthens the association between the eGFR and the risks of adverse outcomes in decreased kidney function. The aim of this cross-sectional study was to investigate the association of cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcreat), the commonly used method to assess kidney function, with periodontitis in 502 Japanese women (average age, 68.6 years). MATERIALS AND METHODS: GFR was estimated from serum cystatin C and serum creatinine, respectively, using the Japanese equation for GFR. Participants were classified into five groups according to their eGFRcys and eGFRcreat values. Poisson regression models with robust error variance assessed the associations of eGFRcys and eGFRcreat with periodontitis. Tests for trends were performed by fitting the five-category eGFR variables in their continuous form to the regression models. RESULTS: Participants with eGFRcys < 50 ml/min/1.73 m(2) were at significantly higher risk of periodontitis compared with the reference group (≥90 ml/min/1.73 m(2) ) (adjusted relative risk = 2.12, 95% confidence interval = 1.12 to 4.02). Additionally, there was a trend towards a higher risk of periodontitis among participants with lower eGFRcys values (p for trend in the multivariable model = 0.008). In contrast, eGFRcreat did not show a significant association with periodontitis. CONCLUSION: The findings of this study of Japanese older women showed that eGFRcys had a stronger and more linear association with periodontitis than eGFRcreat.

Serum antibody to Porphyromonas gingivalis in metabolic syndrome among an older Japanese population.

BACKGROUND AND OBJECTIVE: Potentially significant associations between metabolic syndrome (MetS) and periodontal disease have been reported in recent studies; however, there is a dearth of literature regarding the relationship of MetS with serum antibody levels to periodontal pathogens. The aim of this cross-sectional study was to investigate the association between MetS and serum antibody to the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) in 216 Japanese individuals aged 79 years. MATERIALS AND METHODS: Serum antibody levels to P. gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was considered as the outcome variable. A multivariable logistic regression model was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with an elevated antibody status. Adjustments for gender, income, education, smoking status, dental-care utilisation patterns and brushing frequency were considered. RESULTS: The prevalence of MetS was 22.2% (n = 48). Study participants with MetS were 2.9 times more likely to have an elevated serum antibody to P. gingivalis (adjusted odds ratio = 2.91, 95% confidence interval = 1.24-6.85) after simultaneous adjustment for other covariates. CONCLUSION: Our findings suggest an independent relationship between MetS and serum antibody levels to P. gingivalis in the Japanese elderly. Additional longitudinal epidemiologic studies with larger, more diversified samples and more complete information are needed to substantiate our findings.

PPARγ gene polymorphism, C-reactive protein level, BMI and periodontitis in post-menopausal Japanese women.

BACKGROUND: Several studies have reported inconsistent results regarding the association between the PPARγPro12Ala polymorphism and obesity. Obese individuals had higher C-reactive protein (CRP) levels compared with those of normal weight, and PPARγ activation could significantly reduce serum high-sensitive CRP level. We have previously suggested that the Pro12Ala polymorphism represents a susceptibility factor for periodontitis, which is a known risk factor for increased CRP level. OBJECTIVES: The aim was to investigate associations between PPARγ gene polymorphism, serum CRP level, BMI and/or periodontitis among post-menopausal Japanese women. MATERIALS AND METHODS: The final sample in this study comprised 359 post-menopausal Japanese women. Periodontal parameters, including PD, CAL and BOP, were measured per tooth. PPARγPro12Ala genotype was determined by PCR-RFLP. Hs-CRP value was measured by a latex nephelometry assay. RESULTS: No significant differences in age, BMI or periodontal parameters were found between the genotypes. The percentages of sites with PD ≥ 4 mm were significantly higher among the hsCRP ≥ 1 mg/l group than the hsCRP < 1 mg/l group (p = 0.003). Positive correlations were found between serum hsCRP levels and the percentages of sites with PD ≥ 4 mm (p = 0.043) in PPARγ Ala allele carriers, and BMI (p = 0.033) in non-carriers. After adjustment for model covariates, BMI was significantly associated with serum hsCRP level. CONCLUSION: The PPARγPro12Ala polymorphism was not independently associated with periodontitis, serum CRP level or BMI in post-menopausal Japanese women. However, serum hsCRP level correlated with periodontitis in Ala allele carriers, and with BMI in non-carriers.

Correlation between SNP genotypes and periodontitis in Japanese type II diabetic patients: a preliminary study.

The present study aims to investigate the correlation between SNP genotype patterns and periodontitis severity in Japanese type II diabetic patients. A cross-sectional study in 43 Japanese diabetic patients with periodontitis was performed. Blood samples were drawn for single nucleotide polymorphism (SNP) analyses and periodontal index (probing pocket depth and clinical attachment level) was subsequently recorded. Twelve functional genes with SNPs that had been shown to be associated with diabetes and/or inflammation were genotyped using a nuclease-mediated SNP-specific ligation method. Subjects with two or more sites with clinical attachment level ≥6 mm and who additionally had one or more sites with pocket depth ≥5 mm were classified as having severe periodontitis. Proportions of risk genotypes/non-risk genotypes between severe and non-severe periodontitis were subsequently compared. A high frequency (21/43 participants, 49%) of adiponectin gene polymorphism (ADIPOQ 45T > G) homozygous risk genotype (TT genotype) was observed in the participants. The frequency of TGF-ß1 SNP (29C > T) risk genotype (TT genotype) in severe periodontitis (34%, n = 11) was significantly higher than in non-severe periodontitis (0%, n = 0) (p = 0.04). Our study suggests that TGF-ß1 SNPs (29C > T) may be used as one of the risk indicators for severe periodontitis in Japanese diabetic patients.

The interaction between beta-3 adrenergic receptor polymorphism and obesity to periodontal disease in community-dwelling elderly Japanese.

OBJECTIVES: The purpose of this study was to elucidate whether the association between beta-3 adrenergic receptor polymorphism and periodontal disease is modified by body weight. MATERIAL AND METHODS: We enrolled 332 postmenopausal women and determined their HbA1C levels (%) and beta-3 adrenergic receptor (rs4994) genotypes. Periodontal parameters including clinical attachment level (CAL) were measured. After selecting subjects for each body mass index (BMI) level, the prevalence rate ratio (PRR) by multiple Poisson regression analysis was calculated to evaluate the relationship between periodontal disease and beta-3 adrenergic receptor polymorphism. The number of sites with CAL≥6 mm was used as a dependent variable, and beta-3 adrenergic receptor genotype [categorized as Arg non-carriers (reference) or Arg carriers], age (y) and HbA1C (%) were adopted as independent variables. We converted the number of probing sites (n) to an offset variable. RESULTS: The PRR of the beta-3 adrenergic receptor genotype for the number of sites of CAL≥6 mm showed a positive association in subjects with BMI≥25.0 and increased markedly with BMI. The PRR in subjects with BMI≥30 was 3.10 (p < 0.0001). CONCLUSION: This study indicates a positive association between periodontal disease and the beta-3 adrenergic receptor genotype in obese individuals.

Comparison of periodontal conditions among three elderly populations in Japan and Germany.

AIM: There is a growing interest in comparing periodontal conditions between countries. This study compared periodontal disease conditions in three elderly populations- one from Japan and two from Germany. MATERIALS AND METHODS: We compared periodontal data of 70-year-old subjects from the Niigata Study with 65-74-year-old subjects from the Study of Health in Pomerania (SHIP) and from West Germany (DMS III). A total of 489, 399 and 549 dentate subjects were analysed, respectively. Recording protocols were standardized. Linear or logistic models were used to compare Niigata Study with SHIP. RESULTS: Elderly German subjects in SHIP and DMS III had significantly more severe periodontal conditions and fewer remaining teeth compared to those in Niigata Study, though differences were less pronounced for DMS III. German subjects showed a significantly different pattern of various periodontal risk factors compared to Japanese subjects. Even after adjustment for putative periodontal risk factors, SHIP subjects still presented significantly higher adjusted values for most periodontal parameters compared to Niigata Study subjects (p < 0.05). CONCLUSIONS: Periodontitis was more prevalent in SHIP compared with Niigata Study, even after comprehensive risk factor adjustment. Only to a very small extent, differences between studies could be explained by the risk factors explored.

Association between low renal function and tooth loss over 5 years.

OBJECTIVES: This longitudinal study evaluated the relationship between low renal function and tooth loss in elderly subjects. MATERIAL AND METHODS: Subjects comprised 406 female subjects (55-74 years old) who agreed to participate in a baseline examination and a follow-up examination after 5 years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5 years. Tooth loss over 5 years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5 years. RESULTS: Results of multiple logistic regression analysis showed that cystatin C change over 5 years, age, number of remaining teeth at baseline, number of sites with ≥4 mm clinical attachment level at baseline and serum 25-hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5 years was 7.70 (p=0.029). CONCLUSION: This study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.