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1568421 
Journal Article 
Periodontitis and diabetes associations with measures of atherosclerosis and CHD 
Southerland, JH; Moss, K; Taylor, GW; Beck, JD; Pankow, J; Gangula, PR; Offenbacher, S 
2012 
Yes 
Atherosclerosis
ISSN: 0021-9150
EISSN: 1879-1484 
222 
1 
196-201 
22440543 
WOS:000302960600031 
Objective: Diabetes has been linked with more severe
periodontal disease and with coronary heart disease (CHD). The purpose of this study was to
determine if periodontal infection was a significant modifier in the risk that diabetes poses for
increased carotid artery intimal-medial wall thickness (IMT) and more advanced atheroma lesions
as reflected in atherosclerotic plaque calcification measured by acoustic shadowing. Methods and
results: Comparisons for analyses of cardiovascular outcomes were performed based upon
periodontitis and diabetes status. Periodontitis was measured using pocket depth and attachment
loss at six sites per tooth. Cross-sectional data on 6048 persons aged 52-74 years were obtained
from the Dental Atherosclerosis Risk in Communities Study. Participants without diabetes (n =
5257) were compared to those with diabetes (n = 791). Dependent variables were thick IMT (> 1
mm), presence of acoustic shadowing, and prevalent CHD. All models were adjusted for the
following covariates: gender, age, race/center, LDL and HDL cholesterol, BMI, triglycerides,
hypertension, smoking, income and education. For multivariate model building, all non-normally
distributed variables were transformed and multivariable logistic regression analyses were
performed to evaluate the relationship between periodontal infection, diabetes, and
cardiovascular outcomes. Individuals with diabetes and with severe periodontitis were found to be
significantly more likely to have IMT > 1 mm [OR = 2.2, (1.4-3.5)], acoustic shadowing [OR = 2.5,
(1.3-4.6)], and CHD [OR = 2.6, (1.6-4.2)] compared to those without diabetes or periodontal
disease. Conclusion: Results from this study suggest that among people with diabetes, periodontal
disease may increase the likelihood of subclinical atherosclerotic heart disease and CHD. (C)
2012 Elsevier Ireland Ltd. All rights reserved. 
Intimal-medial wall thickness; Acoustic shadowing; Metabolic control; Coronary heart disease; Inflammatory mediators; Periodontal disease