Development and validation of a screening model for diabetes mellitus in patients with periodontitis in dental settings
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ORIGINAL ARTICLE
Development and validation of a screening model for diabetes mellitus in patients with periodontitis in dental settings Naichuan Su 1 & Wijnand J. Teeuw 2 & Bruno G. Loos 2 & Madeline X. F. Kosho 2 & Geert J. M. G. van der Heijden 1 Received: 9 January 2020 / Accepted: 8 April 2020 # The Author(s) 2020
Abstract Objectives To identify predictors in patient profiles and to develop, internally validate, and calibrate a screening model for diabetes mellitus (DM) in patients with periodontitis in dental settings Materials and methods The study included 204 adult patients with periodontitis. Patients’ socio-demographic characteristics, general health status, and periodontal status were recorded as potential predictors. The diabetic status was considered the outcome, classified into no DM, prediabetes (pre-DM), or DM. Multinomial logistic regression analysis was used to develop the model. The performance and clinical values of the model were determined. Results Seventeen percent and 47% of patients were diagnosed with DM and pre-DM, respectively. Patients’ age, BMI, European background, cholesterol levels, previous periodontal treatment, percentage of the number of teeth with mobility, and with gingival recession were significantly associated with the diabetic status of the patients. The model showed a reasonable calibration and moderate to good discrimination with area under the curve (AUC) values of 0.67 to 0.80. The added predictive values for ruling in the risk of DM and pre-DM were 0.42 and 0.11, respectively, and those for ruling it out were 0.05 and 0.17, respectively. Conclusions Predictors in patient profiles for screening of DM and pre-DM in patients with periodontitis were identified. The calibration, discrimination, and clinical values of the model were acceptable. Clinical relevance The model may well assist clinicians in screening of diabetic status of patients with periodontitis. The model can be used as a reliable screening tool for DM and pre-DM in patients with periodontitis in dental settings. Keywords Periodontitis . Diabetes mellitus . Screening . Predictors Clinical trial registration The dataset used for this manuscript is based on an observational (non-randomized and non-treatment) design. The outcomes of the observational design have been published previously (see Teeuw et al., 2017). The study has been given ethical clearance (2013.343) from the Medical Ethics Review Committee of VU University Medical Center Amsterdam (VUmc), and the PI of this study decided not to register the project since it does not involve randomization of treatment. The study data not being registered in a trial register invalidates neither the initial observational study as published nor the current manuscript. That is, for the current manuscript, the dataset of the already published observational design is used for other purposes, being predictive diagnostic modeling. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03281-w) contains supplementary
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