There has been a lasting hypothesis among researchers that there is a link between insulin resistance and periodontal disease. A recent study in South Korea has put that hypothesis to the test and found in favor of the theory.
What is Insulin Resistance?
Insulin is a hormone that is produced by the human pancreas that helps transfer sugar from the blood to cells. The cells absorb the sugar, or glucose, from the blood and then use that sugar as energy. When carbohydrates are consumed, which happens when you eat, they are released into the blood as glucose. At this point, insulin is released by the pancreas allowing the body to maintain a healthy level of glucose in the blood. The result of this process is that your blood sugar remains at an acceptable level and energy is produced.
If your pancreas is producing insulin but the cells are not using the insulin as well as they are expected to, it’s referred to as insulin resistance. With this condition, the cells are not absorbing the glucose as it should and this leads to a buildup of glucose in the blood. If your blood glucose levels are higher than normal but are not quite high enough to be considered type 2 diabetes, you are said to have prediabetes. It is still unknown why some people show insulin resistance while others don’t but being overweight or obese are known risk factors.
Researchers from South Korea and the United States have collaborated on a new study which looked into the link between insulin resistance and severe periodontal disease. The hypothesis, based on multiple previous studies on the subject, was that those with insulin resistance were at a higher risk of having more severe periodontitis than those that are not insulin resistant.
While past studies have indicated that insulin resistance could cause periodontitis to be more severe, this study aimed to be the first to account for body weight. The reason for this is that being overweight is a risk factor for insulin resistance and can cause diabetes. Studies have also indicated that there is a link between periodontal disease and diabetes so it’s understood that someone that is overweight could be at a greater risk of periodontal disease.
Using data that was provided by the Korea National Health and Nutrition Examination Survey between 2008 and 2010, the study looked at 5,690 South Korean participants. All of the participants in the study were 30 years of age or older and had either moderate or severe periodontal disease as rated by the Community Periodontal Index. 4,500 of the participants had moderate periodontitis, 3.5 millimeter to 5.5 millimeter pockets, and 1,202 participants had severe periodontitis, 5.5 millimeter pockets or deeper.
To find how insulin resistance affects periodontitis, the researchers examined the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores. These scores quantify the participants insulin resistance by multiplying their fasting insulin levels and fasting glucose levels. For males, the researchers considered a HOMA-IR score of 2.21 or higher insulin resistant, or metabolically obese. For females, the researchers considered a HOMA-IR score of 2.33 or higher to be insulin resistant. If any of the participants had been previously diagnosed with type 2 diabetes, they were labeled as insulin resistant as well.
The study found that the participants that had severe periodontitis had much higher insulin resistance than those that only had moderate periodontal disease. Adding in the weight factor, the study found that participants that were of normal weight and were insulin resistant were at a much higher risk of severe periodontitis than those of normal weight that were not insulin resistant. Additionally, it found that those that had previously been diagnosed with type 2 diabetes were more likely to have severe periodontitis.
While the study’s results do not allow the researchers to say definitively that insulin resistance has an impact on the severity of periodontitis, the results of the study certainly indicate the hypothesis. This study is in line with previous studies which have produced similar findings. The difference with this study is that it also takes into account weight considerations, an important factor that had previously been left out. With these new findings, researchers have taken a deeper look into what can be considered a risk factor of severe periodontitis allowing those with insulin resistance to receive proper treatment.