OBJECTIVE Shortened leukocyte telomere length (LTL) and diagnosis of
periodontitis are associated with an increased risk of complications and mortality in diabetes. This study investigated the association between LTL,
endotoxemia, and severity of
periodontitis in a large cohort of people with diabetes. RESEARCH DESIGN AND METHODS Six hundred thirty individuals (371 with type 2 and 259 with
type 1 diabetes) were recruited from the University College Hospital in London, U.K. During a baseline visit, blood was collected for standard biochemical tests and
DNA extraction, while a dental examination was performed to determine diagnosis and extent of
periodontitis. LTL was measured by real-time PCR, and
endotoxemia was assessed by the limulus
amoebocyte lysate method. RESULTS Two hundred fifty-five individuals were diagnosed with
gingivitis, 327 with
periodontitis (114 with moderate and 213 with severe disease), and 48 with edentulous. Diagnosis of
periodontitis was associated with shorter LTL (P = 0.04). A negative association between LTL and
endotoxemia was found in the severe
periodontitis and
type 2 diabetes groups (P = 0.01 for both). Shorter LTL was associated with increased extent of
periodontitis (P = 0.01) and increased
insulin resistance (homeostatic model assessment). Multiple adjustments for biochemical, anthropometric, and medication-use variables did not affect the results. CONCLUSIONS LTL is associated with
endotoxemia and diagnosis of
periodontitis in people with diabetes. LTL shortening might represent a novel
biological pathway accounting for previous epidemiological data that documented higher prevalence of diabetes and its complications in people with
periodontitis and vice versa.