Associations Found Between Inflammatory Bowel Disease, Periodontitis

Patients with inflammatory bowel disease (IBD) are at a higher risk of developing periodontitis, according to new research.

A team, led by Giacomo Baima, Department of Surgical Sciences, C.I.R. Dental School, University of Turin, assessed the prevalence and risk indicators of periodontitis in patients with IBD compared to age- and gender-matched control participants without IBD.

In recent studies, investigators supported microbiological and immunological continuum on the gum-gut axis in health and disease.

In the study, the investigators examined 180 patients with IBD, 117 of which were diagnosed with Crohn’s disease, 60 patients with ulcerative colitis, and 3 patients with an unclassified form of IBD. The study also included 180 health controls that were used as a comparison for periodontitis diagnosis (CDC/AAP case definition) and full-mouth periodontal parameters.

The investigators also performed explorative logistic regression models.

IBD and Periodontitis

The results show significantly more participants in the IBD group had moderate or severe periodontitis (85.6% vs 65.6%, P <0.001) and severe periodontitis (36.7% vs 25.6%, P <0.001) than the control group.

The results were also distinct in certain age groups.

For example, the differences were higher in individuals aged 35-50 years and those aged 51-60 years, without significant changes between patients with Crohn’s disease and ulcerative colitis.

Patients with IBD were approximately 3.5 times more likely to have moderate or severe periodontitis (P <0.001), but there was significant variables associated with periodontitis in the whole sample, including older age, the presence of IBD, and higher full-mouth plaque scores.

But within the IBD group, the variables were male gender, IBD-associated surgery, IBD duration, and localization.

Some positive risk indicators for IBD identified in the study were periodontitis severity and higher bleeding scores. Smoking was deemed to be negatively associated with ulcerative colitis.

“Relevant associations between IBD and periodontitis were found, being modified by CD and UC clinical characteristics,” the authors wrote. “Preventive and therapeutic strategies involving the gum-gut axis should be enforced in IBD patients.”

IBD and Malnutrition

Another area in which patients with IBD are at an elevated risk is for malnutrition and sarcopenia.

Recently, a team, led by Arshdeep Singh, MD, Department of Gastroenterology, Dayan and Medical College and Hospital, evaluated the nutritional status of patients with IBD and determined the threshold values of different parameters of nutritional assessment to identify malnutrition.

In the single-center cross-sectional analysis, the investigators examined adult patients with IBD who underwent anthropometry [body mass index (BMI), mid upper arm circumference (MUAC) and triceps-fold thickness (TSF)], body composition analysis and assessment for sarcopenia [hand-grip strength and skeletal muscle index (SMI) at L3 vertebral level)].

The BMI, MUAC, TSF thickness, fat and lean mass, hand-grip strength, and SMI at L3 vertebral level were lower in patients with IBD compared to the healthy control group.

Malnutrition rates were similar between patients with ulcerative colitis and patients with Crohn’s disease. In the ulcerative colitis subgroup, 24.40% (n = 82) were diagnosed with malnutrition, while 28.57% (n = 20) of the Crohn’s disease subgroup were diagnosed with malnutrition.

The study, “Periodontitis Prevalence and Severity in Inflammatory Bowel Disease: A Case-Control Study,” was published online in the Journal of Periodontology.