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Lucy D. Mastrandrea, MD, PhD

An innovative study by Lucy Mastrandrea, MD, PhD, found a trend toward more periodontal disease in obese children with Type 2 diabetes than in other children.

Study Suggests Diabetic Obese Children Prone to Poor Oral Health

Published May 17, 2017

Children with Type 2 diabetes, including those who are obese, tend to have poorer oral health than other children, according to a first-of-its-kind study.

“This is the first study to look at the salivary microbiome in pediatric populations.”
Associate professor of pediatrics

Published March 2 in PLOS One, the study of three groups of children — 19 normal-weight children, 14 obese children and 16 obese children with Type 2 diabetes — found that poor oral health is more common in obese children with type 2 diabetes. The age range for all groups was 10-19.

“We found a trend toward more periodontal disease in obese children with Type 2 diabetes,” says senior author Lucy D. Mastrandrea, MD, PhD, associate professor of pediatrics.

Study Population Does Not Routinely Visit Dentists

The idea for the study was generated by a conversation between Mastrandrea, first author Waleed F. Janem, MD — formerly a pediatric endocrinology fellow — and Harvey A. Berman, PhD, MPH, associate professor of pharmacology and toxicology.

Berman was initially interested in how access to dental health might impact obese adolescents with Type 2 diabetes.

“It turns out that while obese adolescents with Type 2 diabetes typically do have access to dental health, often through federally funded insurance, they do not routinely go to the dentist,” says Mastrandrea, who is also associate chief of the Division of Endocrinology and Diabetes and a pediatric endocrinologist with UBMD Pediatrics.

Attention to Oral Hygiene of Diabetic Children Needed

The connection between poor oral health and adults with diabetes is well-known, she explains. According to the paper, oral inflammation has been detected not just in adults with diabetes, but even in adults with prediabetes.

However, to the researchers’ knowledge, there haven’t been any studies on the oral health of children with obesity or diabetes or on the pediatric microbiome.

“The most important finding of this research is that, like adults, children with Type 2 diabetes appear more vulnerable to periodontal inflammation than normal lean or obese children,” says Frank A. Scannapieco, PhD, DMD, chair and professor of oral biology in the UB School of Dental Medicine and a co-author.

“It provides justification for the need for additional attention to oral hygiene in children with Type 2 diabetes,” he notes.

Laying Groundwork for Further Microbiome Studies

The work also provides an important foundation for further investigations into the microbiome of children.

“This is the first study to look at the salivary microbiome in pediatric populations,” Mastrandrea says. “We know that having inflammation anywhere in your body may influence your microbiome. At the same time, we know that having diabetes may influence your microbiome or, alternatively, that changes in the microbiome may increase your risk for diabetes.”

Mastrandrea is interested in exploring in a longitudinal study, whether better dental care right after diagnosis might help mitigate the trend toward more periodontal disease in children with Type 2 diabetes. She’s also interested in whether the same trends hold true for children with Type 1 diabetes.

Collaborators From Several UB Schools

The microbiome work was carried out at the UB Center for Microbiome Research in the New York State Center of Excellence in Bioinformatics and Life Sciences.

The researchers isolated DNA from the saliva of children and sequenced the bacterial sequences with assistance from Maria Tsompana, PhD, co-author and senior research scientist in the Department of Epidemiology and Environmental Health in UB’s School of Public Health and Health Professions.

Bioinformatics and statistical analyses were provided by Amarpreet Sabharwal, DDS, clinical assistant instructor of periodontics and endodontics and by Jeffrey C. Miecznikowski, PhD, associate professor of biostatistics, both of whom are co-authors.

Elaine Haase, PhD, research associate of oral biology, is also a co-author.