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Association of urinary albumin excretion with periodontal parameters in patients with type 2 diabetes mellitus: a cross-sectional study

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Abstract

Background

Our previous pilot study using patients with type 2 diabetes mellitus in one medical clinic showed an association of urinary albumin excretion, a marker of generalized vascular dysfunction and kidney damage, with periodontitis. The purpose of this study was to confirm the association by increasing the number of patients and medical clinics.

Methods

Participants were 2302 patients (59.9% males, aged 29–93 years) with type 2 diabetes mellitus from 25 medical clinics. Their medical records and information about socioeconomic status and health behavior were collected. Periodontal status was assessed in a nearby dental office. Multiple linear regression analyses were conducted to examine the association of log-transformed urinary albumin-to-creatinine ratio with periodontal parameters after adjusting for sociodemographic status, general health conditions, and health behaviors. The analyses were performed in all subjects and subjects with normoalbuminuria only.

Results

Multiple linear regression analysis showed that mean probing pocket depth (beta: 0.062), percentage of sites with probing pocket depth of 4 mm or deeper (beta: 0.068), percentage of mobile teeth (beta: 0.055), and severity of periodontitis (beta: 0.049) were significantly (p < 0.05) correlated with log-transformed urinary albumin-to-creatinine ratio after adjusting for possible confounders in all subjects. However, no significant associations between urinary albumin-to-creatinine ratio and periodontal parameters were observed in subjects with normoalbuminuria only.

Conclusions

These results suggest that periodontitis is associated with urinary albumin excretion in patients with type 2 diabetes mellitus. Collaboration between medical and dental healthcare providers is needed for treatment of diabetes and periodontitis.

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Acknowledgements

The authors thank Mr. Suguho Takahashi and Ms. Miki Sato (Jiyugaoka Medical Clinic, Obihiro, Japan) for their skillful data collection and management of the research office. The authors also thank members of the Japan Clinicians Diabetes Association (Drs. Koichi Kawai, Hiroshi Takamura, Masato Takaki, Daigaku Uchida, Akiko Hosokawa, Jokichi Suzuki, Koichi Iwasaki, Hideo Ayame, Noriharu Yagi, Mitsutoshi Kato, Yoshifumi Yokomizo, Mitsue Fujita, Hitoshi Minowa, Hikaru Amemiya, Masae Minami, Kazuhiko Takahashi, Hiroaki Horie, Shigeki Yamamoto, and Yasuo Yamana) for their contribution to data collection of medical parameters. The authors also thank participating dentists for their contribution to collection of periodontal health parameters. This study was supported in part by the 8020 Research Grant for fiscal 2018 from the 8020 Promotion Foundation (adopted no. 18-6-16). The funder had no role in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript.

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Authors and Affiliations

  1. Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan

    Michio Tanaka, Tatsuo Yamamoto & Shinya Fuchida

  2. Misaki Naika Clinic, 6-44-9-201 Futawahigashi, Funabashi, Chiba, 274-0805, Japan

    Nobuichi Kuribayashi

  3. Okuguchi Clinic of Internal Medicine, 2-10-12 Chuo, Aoba-ku, Sendai, Miyagi, 980-0021, Japan

    Fuminobu Okuguchi

  4. Isotani Diabetes Clinic, 14-40-2F Okahigashi, Hirakata, Osaka, 573-0032, Japan

    Haruhiko Isotani

  5. Iwamoto Naika Iin, 496-1 Hirota-cho, Zentsuji, Kagawa, 765-0071, Japan

    Masahiro Iwamoto

  6. Sugimoto Clinic, 1-13-6 Nakasone, Kokuraminami-ku, Kitakyushu, Fukuoka, 800-0222, Japan

    Hidekatsu Sugimoto

  7. Nakagawa Internal Medicine Clinic, 2-2-18 Higashisanjo, Sanjo, Niigata, 955-0047, Japan

    Osamu Nakagawa

  8. Suzuki Diabetes Clinic, 1-3-24 Aiko, Atsugi, Kanagawa, 243-0035, Japan

    Daisuke Suzuki

  9. Abe Clinic, 16-13 Nakakasugamachi, Oita, Oita, 870-0039, Japan

    Katsushige Abe

  10. Watanabe Clinic, 2-39 Wajo-cho, Nishinomiya, Hyogo, 662-0971, Japan

    Nobuaki Watanabe

  11. Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan

    Masato Minabe

  12. Internal Medicine, Jiyugaoka Medical Clinic, 6-4-3 Nishi 6 jo-minami, Obihiro, Hokkaido, 080-0016, Japan

    Hiroki Yokoyama

Authors
  1. Michio Tanaka
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  2. Tatsuo Yamamoto
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  3. Nobuichi Kuribayashi
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  4. Fuminobu Okuguchi
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  5. Haruhiko Isotani
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  6. Masahiro Iwamoto
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  7. Hidekatsu Sugimoto
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  8. Osamu Nakagawa
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  9. Daisuke Suzuki
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  10. Katsushige Abe
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  11. Nobuaki Watanabe
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  12. Masato Minabe
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  13. Shinya Fuchida
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  14. Hiroki Yokoyama
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Contributions

Michio Tanaka and Tatsuo Yamamoto conceived the idea for the study, participated in its design, performed the statistical analysis, and drafted the manuscript. Fuminobu Okuguchi, Haruhiko Isotani, Masahiro Iwamoto, Hidekatsu Sugimoto, Osamu Nakagawa, Daisuke Suzuki, Katsushige Abe and Nobuaki Watanabe participated in data acquisition and critically revised the manuscript. Nobuichi Kuribayashi and Hiroki Yokoyama helped develop the idea for the study, participated in data acquisition and study design, and edited the manuscript. Masato Minabe and Sinya Fuchida helped develop the idea for the study and critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tatsuo Yamamoto.

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Conflict of interests

Kuribayashi received lecture fees from Mitsubishi Tanabe Pharma Corp. All other authors declare that they have no conflict of interest.

Research involving human participants

The study protocol was approved by the ethics committees of Jiyugaoka Medical Clinic (October 27, 2014, No. 250716) and Kanagawa Dental University July 5, 2016, No. 387; September 12, 2017, No. 446; December 20, 2017, No. 476). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.

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Tanaka, M., Yamamoto, T., Kuribayashi, N. et al. Association of urinary albumin excretion with periodontal parameters in patients with type 2 diabetes mellitus: a cross-sectional study. Diabetol Int 11, 121–128 (2020). https://doi.org/10.1007/s13340-019-00413-w

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  • DOI: https://doi.org/10.1007/s13340-019-00413-w

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