Authors
Chenglu Ruan, Huayuan Yang, Lin Wang
Published in
Diabetes research and clinical practice. Pages 113569. Sep 16, 2026. Epub Sep 16, 2026.
Abstract
To test whether countries exhibit reproducible joint longitudinal patterns of periodontal disease and type 2 diabetes burden rather than a homogeneous global trajectory.
This ecological study analysed age-standardised incidence, prevalence and disability-adjusted life-year rates for both conditions in 204 countries. Six annual trajectories were log-transformed, standardised and clustered using multivariate dynamic time warping with partitioning around medoids. Stability was assessed by 200 country-bootstrap replicates, an earlier observation window and principal-component k-means clustering.
Three ecological trajectory phenotypes were identified, comprising 19, 89 and 96 countries. They represented diabetes-dominant with periodontal decline, lower diabetes with intermediate periodontal burden, and high joint burden. The median bootstrap adjusted Rand index was 0.866; earlier-window and alternative-algorithm indices were 0.911 and 0.900, respectively. Shape-only clustering showed minimal agreement (0.010), indicating that burden magnitude materially defined the groups.
National periodontal and type 2 diabetes burdens do not follow a single shared pattern. Reproducible ecological groupings may support integrated oral and metabolic health planning, but they neither demonstrate individual comorbidity nor establish a causal relationship.
PMID:
42749192
Bibliographic data and abstract were imported from PubMed on 17 Sep 2026.
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