Andreas Grigoriadis1,2, Ismo T Räisänen3, Pirjo Pärnänen3, Taina Tervahartiala3, Timo Sorsa3,4, Dimitra Sakellari1. 1. Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece. 2. 424 General Military Training Hospital, Thessaloniki, Greece. 3. Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVE: The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics. MATERIAL AND METHODS: Α chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase-8 levels (aMMP-8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full-mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded. RESULTS: Thirty-one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age ≥45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c < 5.7 and ≥5.7% (Pearson's Chi-square test, p > .05). Subgroups differed regarding BMI (kg/m2 ), tooth count, percentages of 4 and 5 mm pockets (Mann-Whitney and z-test, p < .05). The diagnostic performance for HbA1c ≥5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age ≥ 45 years and BMI (AUC 0.651, p = .010), the above and aMMP-8 (AUC 0.660, p = .006), age ≥ 45 years, BMI and Stage of Periodontitis (AUC 0.711, p < .001) and age ≥ 45 years, BMI, aMMP-8 and stage of periodontitis (AUC 0.713, p < .001). CONCLUSIONS: Findings of the study suggest that the combination of stage of periodontitis, increasing age, BMI and aMMP-8, without chairside HbA1c assessment appears to be a viable screening strategy for referring dental patients for testing for prediabetes/diabetes.
OBJECTIVE: The aim of the study was to propose an efficient chairside clinical strategy for the identification of undiagnosed hyperglycaemia in periodontal clinics. MATERIAL AND METHODS: Α chairside system was used for assessment of glycated hemoglobin 1c (HbA1c) and active Matrix Metalloproteinase-8 levels (aMMP-8) were analyzed by immunotest in patients (n = 150) who fulfilled the criteria for screening of the Centers for Disease Control and Prevention. Full-mouth periodontal parameters were assessed and various data such as Body Mass Index (BMI), smoking and education were recorded. RESULTS: Thirty-one patients out of 150 tested were found with unknown hyperglycaemia (20.7%). Regarding sex, education, parent with diabetes, normal BMI, smoking, age ≥45 years and prior testing for diabetes, no differences were observed between subjects displaying HbA1c < 5.7 and ≥5.7% (Pearson's Chi-square test, p > .05). Subgroups differed regarding BMI (kg/m2 ), tooth count, percentages of 4 and 5 mm pockets (Mann-Whitney and z-test, p < .05). The diagnostic performance for HbA1c ≥5.7 was tested by Receiving Operator Characteristic curves and Areas Under the Curve (AUC) for the following: age ≥ 45 years and BMI (AUC 0.651, p = .010), the above and aMMP-8 (AUC 0.660, p = .006), age ≥ 45 years, BMI and Stage of Periodontitis (AUC 0.711, p < .001) and age ≥ 45 years, BMI, aMMP-8 and stage of periodontitis (AUC 0.713, p < .001). CONCLUSIONS: Findings of the study suggest that the combination of stage of periodontitis, increasing age, BMI and aMMP-8, without chairside HbA1c assessment appears to be a viable screening strategy for referring dental patients for testing for prediabetes/diabetes.
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