What does oral hygiene have to do with your odds of diabetes? As it turns out–quite a lot.
In a recent study, Tokyo researchers have identified poor oral hygiene as a risk factor for metabolic diseases. This group of conditions increases the risk for ailments such as heart disease, stroke, and diabetes. Researchers from Tokyo Medical and Dental University (TMDU) discovered the bacterium which causes periodontal disease: Porphyromonas gingivalis.
Furthermore, they found that this bacteria causes skeletal muscle metabolic dysfunction, leading to metabolic syndrome. This occurs by altering the composition of the gut microbiome. Scientists have known for some time that periodontal bacteria can cause inflammation in the mouth. However, they have recently found that the bacteria can result in inflammation throughout the whole body.
Chronic inflammation as a result of sustained infection due to periodontal bacteria can therefore cause other problems. Common issues that arise include increases in body weight, insulin resistance, and type 2 diabetes. Of course, insulin helps to carry glucose from the blood into tissues throughout the body – most importantly, skeletal muscle. Muscles store 25% of the body’s glucose.
Insulin resistance occurs when the cells in your muscles, fat, and liver can’t process insulin correctly. When the cells can’t utilize glucose in your blood for energy, the pancreas responds by creating more insulin. As a result, your blood sugar goes up, which can lead to type 2 diabetes over time.
The impact of insulin
- high blood pressure
- high blood glucose levels
- chronic inflammation
- inhibited lipid metabolism
- type 2 diabetes
- heart disease
According to WebMD, insulin resistance could affect as many as 1 in 3 Americans.
Some signs of insulin resistance include:
- A waistline over 40 inches in men and 35 inches in women
- Blood pressure readings of 130/80 or higher
- A fasting glucose level over 100 mg/dL
- A fasting triglyceride level over 150 mg/dL
- A HDL cholesterol level under 40 mg/dL in men and 50 mg/dL in women
- Skin tags
- Patches of dark, velvety skin called acanthosis nigricans
Risk Factors and Causes of Insulin Resistance
- Obesity, especially belly fat
- Sedentary lifestyle
- Diet high in carbohydrates
- Gestational diabetes
- Health conditions like nonalcoholic fatty liver disease and polycystic ovary syndrome
- A family history of diabetes
- Being of African, Latino, or Native American ethnicity
- Being older than 45
- Hormonal disorders like Cushing’s syndrome and acromegaly
- Medications like steroids, antipsychotics, and HIV medications
- Sleep problems like sleep apnea
More recently, researchers have added poor oral hygiene to the list of risk factors. It’s been well-established in the scientific community that more muscle people usually have lower blood glucose levels. However, they have just begun to establish the connection between periodontal disease and skeletal muscle’s metabolic function.
“Metabolic syndrome has become a widespread health problem in the developed world,” says the first author of the study Kazuki Watanabe. “The goal of our study was to investigate how periodontal bacterial infection might lead to metabolic alterations in skeletal muscle and thus to the development of metabolic syndrome.”
How researchers found the connection between poor oral hygiene and metabolic disease
Researchers first analyzed antibody levels against Porphyromonas gingivalis in the blood of patients with metabolic syndrome to perform the study. Researchers found a positive correlation between these antibody levels and higher insulin resistance. Thus, the results revealed that patients with metabolic syndrome likely had a past infection with Porphyromonas gingivalis. Therefore, their immune system had antibodies against the invading bacteria.
To understand how poor oral hygiene can cause metabolic disease, the team performed a study on mice. They gave mice on a high-fat diet the bacterium Porphyromonas gingivalis by mouth. (A high-fat diet is a precursor to developing metabolic syndrome). Not surprisingly, the mice developed higher insulin resistance. They also had lower glucose uptake and increased fat in their muscles than mice in the control group.
However, they still didn’t know how the bacteria led to chronic inflammation and eventually metabolic syndrome. To understand the mechanism behind it, the team turned their attention to the gut microbiome. This refers to the total of the bacteria in the gut, where much of the immune system exists. Interestingly, mice given the Porphyromonas gingivalis bacteria had a drastically altered gut microbiome, which may decrease insulin sensitivity.
“These are striking results that provide a mechanism underlying the relationship between infection with the periodontal bacterium Porphyromonas gingivalis and the development of metabolic syndrome and metabolic dysfunction in skeletal muscle,” says corresponding author of the study Professor Sayaka Katagiri.