Objectives Recent studies have shown a bidirectional association between diabetes and periodontal disease. However, the longitudinal association between periodontal pocket depth and new onset of diabetes remains controversial. Therefore, this study aimed to examine the association between periodontal pocket depth and new onset of diabetes using dental check-up data in a community-based population.
Methods The study comprised 5,163 participants aged≥20 years (mean age±standard deviation, 57.4±13.9 years; women, 66.3%) who underwent dental check-ups between April 2016 and March 2019 in a Tokyo ward. We classified the participants into three groups using community periodontal index codes from dental check-ups: healthy periodontal pocket group, periodontal pocket 4-5 mm group, and periodontal pocket ≥6 mm group. The participants were followed until the end of March 2020. Additionally, data on individuals who developed diabetes in the same ward were acquired from the National Health Insurance and Latter-Stage Older Persons Health Care System using ICD-10 codes. As the study outcome, we identified individuals who developed diabetes after the dental check-up date. Diabetes incidence rates were compared using the log-rank test and Cox regression analysis. Additionally, we performed a sensitivity analysis using a similar framework.
Results The log-rank test showed that the cumulative incidence of diabetes between the three groups was significantly different (P<0.01). A Cox regression analysis model adjusted for sex, age, smoking habits, number of teeth present, and oral hygiene status showed that the diabetes development hazard ratio (HR) for the periodontal pocket ≥6 mm group was 1.44 (95% confidence interval [CI]; 1.04-2.00) when compared with that of the healthy periodontal pocket group. In the sensitivity analysis of individuals aged ≥40 years, the HR for the periodontal pocket ≥6 mm group was 1.55 (95% CI; 1.11-2.16) when compared with that of the healthy periodontal pocket group. Similarly, among men aged ≥40 years, the HR for the periodontal pocket ≥6 mm group was 1.72 (95% CI; 1.04-2.85) when compared with that of the healthy periodontal pocket group. However, no significant association between new onset of diabetes and periodontal pocket depth was found for women aged ≥40 years (HR=1.39, 95% CI; 0.89-2.18).
Conclusion This The study suggests a longitudinal association between periodontal pocket depth and new onset of diabetes. The association was particularly pronounced in men aged ≥40 years. Therefore, men aged <40 years should maintain good oral health through appropriate dental health guidance to prevent the future development of diabetes.
"},{"@language":"ja","@value":"目的 近年，糖尿病と歯周病には双方向の関連性があることが多数報告されている。しかしながら，歯周ポケットの深さと糖尿病の新規発症に関する縦断的な関連性についてはさらなる議論の余地がある。従って，本研究は地域住民における成人歯科健診データを用いて，歯周ポケットの深さと糖尿病の新規発症の関連性を検証することを目的とした。
方法 本研究は，東京都某区で2016年4月から2019年3月までに成人歯科健診を受診した20歳以上の成人5,163人（57.4±13.9歳，女性66.3％）を対象として，歯科健診の歯周ポケットコードを用いて歯周ポケット健全群，4～5 mm群，6 mm以上群の3群に分類し2020年3月末日まで追跡を行った。さらに同区の国民健康保険および後期高齢者医療保険の医科レセプトデータ傷病名から，疑い病名を除く糖尿病のICD10コードを抽出し，歯科健診の受診日以降に発症した者を糖尿病ありと定義してアウトカムに用いた。糖尿病発症率の比較にはログランク検定及びCox比例ハザード回帰分析を用いた生存時間分析と感度分析を行った。
結果 ログランク検定の結果，3群間の糖尿病累積発症率は有意に異なっていた（P<0.01）。また，性別，年齢，喫煙習慣，現在歯数，口腔清掃状態を調整したCox比例ハザード回帰分析の結果，歯周ポケット健全群に対する6 mm以上群の調整ハザード比（95％信頼区間）は1.44（1.04-2.00）倍の有意な関連性が認められた。さらに40歳以上を対象とした感度分析の調整ハザード比（95％信頼区間）は歯周ポケット健全群に対して6 mm以上群が1.55（1.11-2.16）倍，40歳以上の男性では1.72（1.04-2.85）倍の有意な関連性を認めた。しかし，40歳以上の女性には有意な関連性は認められなかった（1.39［0.89-2.18］）。
結論 本研究の結果，地域住民において歯周ポケットの深さと糖尿病の発症に関する縦断的な関連性が示唆された。特に，40歳以上の男性においてその関連性が顕著であったことから，40歳未満の若年層とりわけ若い男性に対して適切な歯科保健指導を実践し口腔状態を良好に保つことは口腔衛生の観点のみならず，将来的な糖尿病予防の観点からも重要であると考えられる。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410294807623393921","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"谷 直道"},{"@language":"en","@value":"TANI Naomichi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院医療経営・管理学講座"},{"@language":"en","@value":"The Association for Preventive Medicine of Japan"},{"@language":"ja","@value":"一般財団法人日本予防医学協会"}]},{"@id":"https://cir.nii.ac.jp/crid/1410294807623393920","@type":"Researcher","foaf:name":[{"@language":"en","@value":"TAKEUCHI Kenji"},{"@language":"ja","@value":"竹内 研時"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"東北大学大学院歯学研究科国際歯科保健学分野"},{"@language":"en","@value":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry"},{"@language":"en","@value":"Department of Preventive Medicine, Nagoya University Graduate School of Medicine"},{"@language":"ja","@value":"名古屋大学大学院医学系研究科予防医学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410294807623393922","@type":"Researcher","foaf:name":[{"@language":"en","@value":"FUKUDA Haruhisa"},{"@language":"ja","@value":"福田 治久"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院医療経営・管理学講座"},{"@language":"en","@value":"Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"05461766"},{"@type":"EISSN","@value":"21878986"},{"@type":"NDL_BIB_ID","@value":"000000018406"},{"@type":"ISSN","@value":"05461766"},{"@type":"LISSN","@value":"05461766"},{"@type":"NCID","@value":"AN00189323"}],"prism:publicationName":[{"@language":"ja","@value":"日本公衆衛生雑誌"},{"@language":"en","@value":"Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)"},{"@language":"ja","@value":"日本公衛誌"},{"@language":"en","@value":"Jpn J Public Health"},{"@language":"en","@value":"Nihon Koshu Eisei Zasshi"},{"@language":"en","@value":"JAPANESE JOURNAL OF PUBLIC HEALTH"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society of Public Health"},{"@language":"ja","@value":"日本公衆衛生学会"}],"prism:publicationDate":"2023-01-15","prism:volume":"70","prism:number":"1","prism:startingPage":"39","prism:endingPage":"47"},"url":[{"@id":"http://id.ndl.go.jp/bib/032596137"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I032596137"},{"@id":"https://search.jamas.or.jp/link/ui/2023197809"}],"availableAt":"2023-01-15","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E7%B3%96%E5%B0%BF%E7%97%85","dc:title":"糖尿病"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%AD%AF%E5%91%A8%E3%83%9D%E3%82%B1%E3%83%83%E3%83%88","dc:title":"歯周ポケット"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%8F%A3%E8%85%94%E8%A1%9B%E7%94%9F","dc:title":"口腔衛生"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%AD%AF%E7%A7%91%E5%81%A5%E8%A8%BA","dc:title":"歯科健診"},{"@id":"https://cir.nii.ac.jp/all?q=%E7%B8%A6%E6%96%AD%E7%A0%94%E7%A9%B6","dc:title":"縦断研究"},{"@id":"https://cir.nii.ac.jp/all?q=diabetes%20mellitus","dc:title":"diabetes mellitus"},{"@id":"https://cir.nii.ac.jp/all?q=periodontal%20pocket%20depth","dc:title":"periodontal pocket depth"},{"@id":"https://cir.nii.ac.jp/all?q=oral%20hygiene","dc:title":"oral hygiene"},{"@id":"https://cir.nii.ac.jp/all?q=dental%20check-ups","dc:title":"dental check-ups"},{"@id":"https://cir.nii.ac.jp/all?q=longitudinal%20study","dc:title":"longitudinal study"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360025431090832512","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Periodontal disease and the incident risk of diabetes mellitus in Japanese men and women: a 12-year cohort study"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2010062947"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I032596137"},{"@type":"PUBMED","@value":"36310065"},{"@type":"CROSSREF","@value":"10.1007/s13340-025-00815-z_references_DOI_QkS6ob1W8BaMssnpkpAHeTqnzSz"}]}