The extent of alveolar bone loss is associated with impaired glucose tolerance in Japanese men

Background: The treatment of periodontal disease in diabetic patients is reported to have a beneficial effect on their glucose control. A recent study indicated that having deep pockets is significantly associated with past development of glucose intolerance in non-diabetic individuals using an oral glucose tolerance test (OGTT). These findings suggest that periodontal disease is a risk factor for diabetes, although more evidence is needed. Methods: A total of 193 Japanese men aged 50 to 54 years with at least 10 teeth were examined as part of a comprehensive health examination before retirement from the Japan Self-Defense Force. Alveolar bone loss of the posterior teeth was measured on a panoramic x-ray film. An OGTT was administered and impaired glucose tolerance (IGT) and diabetes were defined. The relationships between the mean ratio of alveolar bone loss to root length and OGTT results were analyzed after adjusting for known risk factors for diabetes. Results: The proportion of subjects with IGT increased significantly in the subjects with higher tertiles of alveolar bone loss (P <0.05). In the multivariate logistic regression analysis excluding diabetic subjects, the adjusted OR for IGT to normal glucose tolerance (NGT) increased in subjects with higher tertiles of alveolar bone loss (P for trend = 0.03). In the subjects with the highest tertile of alveolar bone loss, the adjusted OR for IGT to NGT was 4.27 (95% confidence interval [CI]: 1.41 to 12.9; P = 0.01). Conclusion: The degree of alveolar bone loss is significantly associated with IGT, suggesting that periodontitis with alveolar bone loss is associated with impaired glucose tolerance.