ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1564094
This article is part of the Research TopicThe Impact of Diabetes and Obesity on PeriodontitisView all articles
Diabetes: a potential mediator between obesity and periodontitis risks
Provisionally accepted
- 1Qingdao Stomatological Hospital, Qingdao, Shandong Province, China
- 2Qingdao Municipal Hospital, Qingdao, Shandong Province, China
- 3Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Background: Obesity and diabetes mellitus (DM) are well-established risk factors for periodontitis, a chronic inflammatory disease with significant oral and systemic implications. While the associations between these conditions have been extensively studied, the extent to which diabetes mediates the effect of obesity on periodontitis risk remains to be quantitatively elucidated.Objectives: This study aimed to evaluate the mediating effect of diabetes on the link between obesity and periodontitis risk Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES, 2009-2012), including 8,473 participants. Body mass index (BMI) and waist circumference were used as measures of obesity, while diabetes was diagnosed based on selfreported data, clinical measurements, and laboratory results. Periodontitis was assessed using clinical attachment loss and probing depth. Statistical analyses included multivariable logistic regression, mediation analysis, and nonlinear relationships using restricted cubic splines.The analysis showed a significant positive association between both BMI and waist circumference with periodontitis risk (P<0.05). Diabetes was found to be an independent risk factor for periodontitis, with a significant positive correlation (P<0.01). Mediation analysis revealed that diabetes mediated 24.99% of the effect of BMI and 22.11% of waist circumference on periodontitis risk. Nonlinear analyses did not indicate significant non-linear trends in the relationship between obesity and periodontitis risk.Conclusions: While obesity is associated with increased periodontitis risk, this association is also indirectly enhanced via diabetes-related metabolic and inflammatory pathways.
Keywords: Obesity, diabetes, Periodontitis, Mediation analysis, NHANES
Received: 21 Jan 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Jiang, Jing, Mengmeng and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hao Sun, Qingdao Municipal Hospital, Qingdao, 266011, Shandong Province, China
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