Background: Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, age, smoking, diabetes mellitus, as well as socioeconomic and genetic factors. An interleukin (IL)-1 haplotype is associated with periodontitis. We report the relationship between type 2 diabetes, the IL-1A/1B haplotype, and periodontitis in a population-based study.
Methods: In a cross-sectional health survey in northeast Germany, we genotyped 1,515 subjects aged 40 to 60 years for the IL-1 genotype, examined their periodontal status, and assessed diabetes, including the history of diagnosed diabetes, the use of antidiabetic medications, and hemoglobin A(1c) (HbA(1c)) measures.
Results: Subjects with increased levels of HbA(1c) had more widespread and severe periodontal disease than normoglycemic subjects. There is a gene-environmental interaction because diabetic subjects bearing a variant IL-1 genotype C/T or T/T had an enhanced risk for periodontal disease in comparison with their IL-1 wild-type counterparts. Bleeding on probing (P = 0.007), attachment loss (P = 0.009), and number of teeth (P <0.001) were associated significantly with diabetes and the IL-1 genotype. Logistic regression and a matched-pair analysis confirmed these results.
Conclusion: Subjects with type 2 diabetes have an increased risk for periodontitis, which is aggravated further if combined with the variant IL-1A/1B genotype.