Evidence map›Paper›PMID 41420165›Full record

Observational studyBMC endocrine disorders2025

The role of periodontitis as a modifier of diabetes mellitus in older patients with atrial fibrillation.

Takahiro Kamihara, Yuiko Yokoyama, Junya Nakamura, Masaharu Murakami, Yoshihiro Kugimiya, Yosuke Ichikawa, Sae Nagai, Honoka Sato, Yu Nakano, Megumi Moriya and 3 more

Abstract readObservational Study
In one paragraph

Observational study in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Takahiro KamiharaDepartment of Cardiology, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan. kamihara@ncgg.go.jp.ORCID http://orcid.org/0000-0003-4592-4170
Yuiko YokoyamaDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Junya NakamuraDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Masaharu MurakamiDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Yoshihiro KugimiyaDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Yosuke IchikawaDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Sae NagaiDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Honoka SatoDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Yu NakanoDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Megumi MoriyaDepartment of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Shinji KanekoDepartment of Cardiology, Toyota Kosei Hospital, Toyota, Japan.
Yasuya IndenDepartment of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Atsuya ShimizuDepartment of Cardiology, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan.

Funding

Japan Society for the Promotion of Science 23K19602 and 24K19046
6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is a common arrhythmia driven by chronic inflammation, which promotes myocardial remodeling. While diabetes mellitus (DM) is known to exacerbate AF inflammation, the specific factors linking DM to AF pathology are complex and often confounded by conditions like periodontitis. This study aimed to determine the true contribution of DM and periodontitis to systemic inflammation in older AF patients, using the Ferritin/Hemoglobin ratio-a surrogate marker for chronic inflammation and impaired iron utilization.

methodsThis single-center, retrospective observational study included older AF patients undergoing catheter ablation (CA), categorized into DM and Non-DM groups. We collected demographic data, cardiac parameters, metabolic indices (HbA1c, and periodontitis markers, including the number of Residual roots and periodontal pocket depth (PPD). Principal Component Analysis (PCA) and subsequent multiple regression were performed using the Ferritin/Hb ratio as the dependent variable to identify independent inflammatory predictors.

resultsThe DM group exhibited a higher inflammatory and metabolic risk profile, including significantly higher Body Mass Index, HbA1c, and C-reactive protein, as well as significantly poorer oral hygiene (higher Residual roots). Multiple regression analysis demonstrated that the number of teeth with PPD > 4 mm was the strongest independent positive predictor of the Ferritin/Hb ratio. Other positive predictors included Left atrium diameter. Notably, the presence of DM itself was not the most influential factor, and the mean PPD showed a paradoxical negative association, suggesting that local lesion severity (PPD > 4 mm count) is more critical than the extent of the disease.

conclusionThe presence of severe periodontal lesions -rather than DM status alone-is independently and significantly associated with systemic inflammation and impaired iron utilization in older AF patients. This indicates that periodontitis acts as a major mediating factor in DM-related AF pathology. We recommend that proactive periodontal treatment and oral hygiene management be integrated alongside optimal glycemic control as crucial therapeutic strategies to suppress AF inflammation. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Atrial FibrillationDiabetes MellitusPeriodontitisAgedBiomarkersFemaleFollow-Up StudiesGlycated HemoglobinHumansInflammationMaleMiddle AgedPrognosisRetrospective StudiesBiomarkersGlycated HemoglobinAtrial fibrillationDiabetes mellitusOlderPeriodontitis

Identifiers

PMID41420165
PMCPMC12831403

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.