Serum vitamin D, hemoglobin A1c and vitamin B12 levels in patients with gingivitis and periodontitis stages

Abstract

Aim: To compare the serum vitamin D, hemoglobin A1c (HbA1c) and vitamin B12 levels in patients with gingivitis and four different periodontitis stages diagnosed according to the 2017 Periodontal Disease Classification. Materials & methods: A total of 606 patients were included in the study who were diagnosed with gingivitis and stage I–IV periodontitis. Patients were divided into groups based on disease stage, and the HbA1c, vitamin D and B12 levels of the patients were compared and analyzed. Result: The highest HbA1c level and the lowest vitamin D level were seen in stage III–IV periodontitis. The highest vitamin D and B12 levels were seen in the gingivitis group. Conclusion: Serum HbA1c, vitamin D and B12 levels might vary depending on the presence or severity of periodontitis.

Clinical Trial Registration: NCT05745779 (This study was registered and approved by www.clinicaltrials.gov)

Clinical Relevance

Scientific rationale for study

In the 2017 American Academy of Periodontology and European Federation of Periodontology Periodontal Disease Classification, periodontitis is divided into stages according to the severity of interdental bone loss. Serum HbA1c, vitamin D and B12 levels might vary depending on the presence of periodontitis or severity of periodontitis (i.e., the severity of interdental bone loss).

Principal findings

HbA1c, vitamin D and B12 levels in the patient group with stage I, II, III and IV periodontitis were different from those in the gingivitis group. The highest HbA1c level and the lowest vitamin D level were seen in stage III–IV periodontitis. The highest vitamin D and B12 levels were seen in the gingivitis group.

Practical implications

A multidisciplinary approach may be recommended for patients diagnosed with stage III and IV periodontitis.

Summary points

• The highest hemoglobin A1c (HbA1c) level and the lowest vitamin D level were seen in patients with stage III–IV periodontitis.

• There was an inverse correlation between vitamin D level and stage, and a same-directional correlation between HbA1c and stage, while no significant correlation was seen with vitamin B12.

• Serum HbA1c, vitamin D, and vitamin B12 levels might vary depending on the presence of periodontitis or severity of periodontitis.

• If a clinician diagnoses a patient with stage III–IV periodontitis, medical consultation may be recommended, and this approach may make an additional contribution to periodontal treatment by identifying and eliminating possible risk factors.

Keywords: :

• HbA1c
• periodontitis
• risk factors
• vitamin B12
• vitamin D

Author contribution

Conceptualization: S Bulut. Formal analysis: D Noyun. Investigation: S Bulut, D Noyun. Methodology: S Bulut, S Ipci, G Cakar. Project administration: S Bulut. Writing – original draft: S Bulut. Writing – review and editing: S Bulut.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval (11 August 2022, no: 2022/77 and clinical trial registration NCT05745779) and/or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.