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Abstract P128: Periodontal Disease and Coronary Artery Calcium in Adults With Type 1 Diabetes


 Introduction:
 Adults with type 1 diabetes (T1D) have at least a two-fold risk of developing coronary artery disease (CAD) compared to adults without diabetes (Non-DM); Periodontal disease is also increased in T1D, due at least in part to hyperglycemia. There is increasing recognition that periodontal disease is linked to CAD through systemic inflammation, which may be a mechanism through which diabetes increases CAD. In this study, we examined the association between self-reported gum disease and coronary artery calcium (CAC) in the prospective Coronary Artery Calcification in Type 1 Diabetes (CACTI) cohort.
 
 
 Methods:
 There were 1416 adults (652 with T1D, 764 Non-DM, mean±SD age 37±8years, 48% men) enrolled in the CACTI cohort in 2000. The cohort completed four visits between 2000 and 2018: at baseline and after 3, 6 and 14 years of follow-up. At each visit, participants self-reported gum disease diagnosis. CAC volume was measured by computed tomography at each visit and was square root transformed for analysis. Linear mixed effects models were used to examine the association between self-reported gum disease and change in CAC volume.
 
 
 Results:
 At baseline, 12% of Non-DM and 16% of T1D participants (p=0.054) reported having gum disease. The prevalence of gum disease increased across visits to 18% in participants with T1D vs. 13% in Non-DM participants at visit 2 (p=0.01); 22% in participants with T1D at visit 3 vs. 14% in Non-DM participants (p=0.0009) and 25% in participants with T1D vs. 17% in Non-DM participants at visit 4 (p=0.023). Self-reported gum disease was associated with a significantly greater increase in CAC volume over time (Table, p<0.0001) among people with T1D, but not in people without diabetes (p=0.13) when adjusted for age, sex, body mass index, LDL cholesterol and smoking (p-value for diabetes x gum disease interaction <0.0001).
 
 
 Conclusion:
 Periodontal disease prevalence was increased in adults with T1D, and was independently associated with increase in CAC volume over 14 years of follow-up in this population.
 
 
 
