Abstract
BACKGROUND: Growing evidence suggests that prediabetes may increase the risk of periodontitis, though the extent of this association remains unclear. To provide a clearer understanding, this meta-analysis focused on observational studies that utilized multivariate analyses to adjust for key confounding factors. MATERIAL AND METHODS: A comprehensive search of PubMed, Embase, and Web of Science was conducted to identify observational studies assessing the relationship between prediabetes and periodontitis. Only studies that utilized multivariate analyses were included to minimize confounding bias. The quality of the studies was evaluated with the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model, with heterogeneity assessed by the I² statistic. RESULTS: Ten observational studies with 38,727 participants were included. Overall, individuals with prediabetes had a significantly higher risk of periodontitis compared to normoglycemic individuals (OR: 1.27, 95% CI: 1.09 to 1.48, p < 0.001) with moderate heterogeneity (I² = 53%). Subgroup analyses revealed a stronger association in studies where the proportion of men was < 45% compared to those ≥ 45% (OR: 1.75 vs. 1.15, p for subgroup difference = 0.01). Studies with lower quality (NOS score = 7) showed a stronger association compared to higher-quality studies (NOS score = 8 or 9, p for subgroup difference = 0.003). CONCLUSION: This meta-analysis found that prediabetes may be independently associated with an increased risk of periodontitis. Further research is needed to explore the mechanisms underlying this association and potential sex-specific effects.