Association of periodontitis stages with glycemic control in adults with and without type 2 diabetes mellitus: a cross-sectional study

Authors

  • Maria Eduarda Oliveira Rodrigues Universidade de Brasília (UnB). Faculdade de Ciências da Saúde, Departamento de Odontologia.
  • Josy Lorena Peres da Silva Vilarinho Universidade de Brasília (UnB). Faculdade de Ciências da Saúde. Departamento de Odontologia.
  • João Gabriel Jucá Chermont Universidade de Brasília (UnB). Faculdade de Ciências da Saúde. Departamento de Odontologia.
  • Cristine Miron Stefani Universidade de Brasília (UnB). Faculdade de Ciências da Saúde. Departamento de Odontologia
  • Valéria Martins de Araújo Carneiro Universidade de Brasília (UnB). Faculdade de Ciências da Saúde., Departamento de Odontologia.
  • Maria do Carmo Machado Guimarães Universidade de Brasília (UnB). Faculdade de Ciências da Saúde. Departamento de Odontologia
  • Bruna Frizon Greggianin Universidade de Brasília (UnB). Faculdade de Ciências da Saúde. Departamento de Odontologia.

DOI:

https://doi.org/10.1590/1678-7765-2026-0178

Keywords:

Periodontitis, Diabetes mellitus, Glycated hemoglobin, Dyslipidemia

Abstract

Objective:  To investigate associations among periodontal parameters, glycated hemoglobin (HbA1c), and metabolic parameters in adults with and without type 2 diabetes mellitus (T2D). Methodology:  A cross-sectional study included 74 adults diagnosed with periodontitis according to the current periodontal classification of 2018. Participants underwent a full-mouth periodontal examination, laboratory assessment, and Body Mass Index (BMI). Periodontitis was categorized into Stages I/II and Stages III/IV. HbA1c, lipid profile, high-sensitivity C-reactive protein (CRP), and insulin resistance (HOMA-IR) were assessed. Periodontal inflammatory burden was quantified using the Periodontal Inflamed Surface Area (PISA). Non-parametric tests and Spearman correlation analyses were performed, stratified by diabetes status (α=5%). Results:  Individuals with advanced periodontitis (Stages III/IV) had significantly higher HbA1c levels (6.8% vs. 5.8%; p=0.007), higher triglyceride concentrations (142.0 vs. 100.5 mg/dL; p=0.016), and lower HDL-cholesterol levels (46.0 vs. 52.0 mg/dL; p=0.012) than those in Stages I/II. Poor glycemic control (HbA1c >8.5%) and T2D duration ≥10 years were significantly associated with advanced stages (p<0.05). No significant differences were observed for BMI, LDL, total cholesterol (TC), CRP, or HOMA-IR between groups. In adults with T2D, PISA correlated positively with TC and LDL-cholesterol, whereas in non-diabetic individuals, PISA was associated primarily with triglycerides. Conclusions:  Advanced periodontitis was associated with poorer glycemic control and a more atherogenic lipid profile, particularly characterized by elevated triglycerides and reduced HDL-cholesterol. The findings support periodontitis as a potential marker of systemic metabolic dysregulation and reinforce the importance of integrating periodontal care into cardiometabolic risk management strategies.

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Published

2026-08-07

Issue

Vol. 34 (2026)

Section

Original Articles

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How to Cite

Rodrigues, M. E. O., Vilarinho, J. L. P. da S., Chermont, J. G. J., Stefani, C. M., Carneiro, V. M. de A., Guimarães, M. do C. M., & Greggianin, B. F. (2026). Association of periodontitis stages with glycemic control in adults with and without type 2 diabetes mellitus: a cross-sectional study. Journal of Applied Oral Science, 34, e20260178. https://doi.org/10.1590/1678-7765-2026-0178