Clinical and epigenetic determinants of edentulism in type 2 diabetic subjects referring to a tertiary center

J Diabetes Complications. 2021 May;35(5):107910. doi: 10.1016/j.jdiacomp.2021.107910. Epub 2021 Mar 16.

Abstract

Aims: Edentulism, extreme consequence of severe periodontitis, carries a high cardiovascular and all-cause death risk. The prevailing phenotype of edentulous patients with type 2 diabetes (T2D) has never been defined, neither it is known whether an epigenetic signature of such condition exists.

Methods: We collected clinical and biochemical data and administered a questionnaire on oral health in 248 consecutive T2D individuals. Vital status was checked after 17 ± 7 months. miRNAs involved in periodontal inflammation were measured.

Results: Forty-seven patients (19%) were edentulous (ED), a higher prevalence than in the Italian general population (10.9% from ISTAT data). ED were older, with low level of instruction and higher fasting glucose vs not edentulous (noED). Participants displayed a scarce awareness of the association periodontitis-T2D. ED showed a specific epigenetic signature (lower miR214-5p and higher miR126-5p urinary levels). At the follow-up, metabolic profile similarly improved in ED and noED; death occurrence was similar.

Conclusions: In this cohort of T2D, age is the only variable associated with edentulism; such condition displays an epigenetic signature, independent of the clinical phenotype; awareness of the clinical relevance and implications of periodontitis and edentulism are scarce. However, edentulism does not mark an increased rate of micro-macrovascular complications or mortality.

Keywords: Cardiovascular risk; Edentulism; Epigenetics; Oral hygiene; Type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / genetics
  • Epigenesis, Genetic*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth, Edentulous* / epidemiology
  • Mouth, Edentulous* / genetics
  • Periodontitis* / epidemiology
  • Periodontitis* / genetics