Association of periodontitis with type 2 diabetes and obesity in a sample of Egyptian population: a cross-sectional study

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BACKGROUND: Periodontitis, a chronic inflammatory disease of tooth-supporting tissues, shows significant associations with systemic conditions like type 2 diabetes mellitus (T2DM) and obesity. These metabolic disorders share chronic inflammatory pathways that may influence periodontal disease severity. This study investigated these relationships using advanced quantifiable metrics - periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA). METHODS: In this cross-sectional study, 378 adults with T2DM and periodontitis underwent comprehensive evaluation including anthropometric measures (BMI, waist circumference, visceral fat area [VFA]) and periodontal examinations (probing depth, clinical attachment level, bleeding on probing). PISA and PESA were calculated to quantify inflammatory burden. Associations were assessed using Spearman's correlation and multivariable regression. RESULTS: Participants with elevated obesity measures (BMI ≥ 25 kg/m², VFA ≥ 100 cm²) demonstrated significantly higher median PISA (255.0 vs. 187.0 mm²) and PESA (1333.5 vs. 936.0 mm²) values (p < 0.001). HbA1c showed strong positive correlations with both PISA and PESA (r = 0.66, p < 0.001). Moderate correlations emerged for BMI (r = 0.28-0.29), waist circumference (r = 0.34), and fasting glucose (r = 0.28) (all p < 0.001), while VFA showed weaker association (r = 0.11, p < 0.05). CONCLUSION: PISA and PESA effectively quantify periodontal inflammation and its significant associations with metabolic parameters. The findings support integrated patient care approaches that consider both periodontal and metabolic health, with potential value in monitoring HbA1c and obesity measures during periodontal management.

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