Abstract
BACKGROUND: Immunoglobulin G (IgG) antibodies against periodontal microorganisms can be markers of periodontal infection because their levels rise following infection and remain elevated several years later. METHODS: We evaluated the relationship between groups of IgG antibodies against 19 periodontal microorganisms and diabetes-related mortality over 27 years among participants of the National Health and Nutrition Examination Survey III (1988 to 1992) aged ≥40 years at the time of examination (N = 8,153). RESULTS: Individuals in the highest versus lowest antibody tertiles were at 86% higher risk of dying due to diabetes-related causes in the Red-Green antibody cluster (T. forsythia, T. denticola, A. actinomycetemcomitans, E. corrodens, S. noxia, V. parvula, C. rectus) (hazard ratio [HR], 1.86; 95% CI, 1.09 to 3.20) and 55% lower in the Orange-Blue antibody cluster (E. nodatum, A. naeslundii) (HR, 0.45, 95% CI, 0.32 to 0.63) in multivariable models. In these models, individuals with diabetes at the time of examination had a 16-fold higher risk of dying due to diabetes-related causes (HR, 16.4; 95% CI, 11.0 to 24.7). CONCLUSION: As a subset of periodontal microorganisms are associated with adverse systemic outcomes, antibody profiles may help in prediction of diabetes-related mortality and identify subgroups of individuals among whom periodontal treatment may impact diabetes-related outcomes.