J Clin Periodontol. 2021 Dec 5. doi: 10.1111/jcpe.13578. Online ahead of print.
ABSTRACT
AIM: This study aimed to determine whether periodontitis in early pregnancy and periodontal therapy during gestation affect the incidence of gestational diabetes mellitus (GDM) through a population-based clinical study.
MATERIALS AND METHODS: Subjects without periodontitis at 1-4 weeks of gestation who met our inclusion criteria were enrolled in the Nonperiodontitis group. Periodontitis patients who agreed or refused to receive periodontal therapy during pregnancy were enrolled in the Periodontitis Treated or Untreated group, respectively. At 12-16 weeks of gestation, gingival crevicular fluid (GCF) and venous blood were collected for analyses of bacterial species and serum inflammatory mediators, respectively. At 24-28 weeks of gestation, GDM patients were identified by oral glucose tolerance tests. The association tests were performed using chi-squared statistics and regression analyses.
RESULTS: The complete data of 3523 pregnant women were recorded during the study period. The GDM incidence among the untreated periodontitis participants (84/749, 11.21%) was significantly higher than that among the nonperiodontitis participants (108/2255, 4.79%) (P < 0.05), and periodontal treatment during gestation reduced the incidence from 11.21% (untreated group) to 7.32% (38/519, treated group) (P < 0.05). Based on the multiple logistic regression analyses, periodontitis in early pregnancy was associated with GDM, and the three-step regression analyses showed that Porphyromonas gingivalis (P. gingivalis) and the serum TNF-α and IL-8 levels played roles in the association between untreated periodontitis and GDM. Furthermore, Pearson’s correlation test indicated that the existence of P. gingivalis in GCF was positively correlated with high serum levels of these two inflammatory mediators.
CONCLUSION: This study establishes a connection between periodontitis in early pregnancy and GDM and demonstrates that the presence of P. gingivalis is associated with high serum levels of inflammatory mediators, thereby may contribute to the development of GDM. In-depth mechanistic studies are needed to further support these findings. This article is protected by copyright. All rights reserved.
PMID:34865247 | DOI:10.1111/jcpe.13578
