OBJECTIVE: This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis).
METHODS: Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.
RESULTS: Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29).
CONCLUSIONS: Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.

OBJECTIVE: Glycosylated haemoglobin (HbA1c), a marker of diabetic glycemic control, is associated with chronic psychosocial stress in non-diabetic adults. This study aimed to determine whether HbA1c also acts as a biomarker of psychosocial stress in healthy 6-year-olds.
METHODS:
METHODS: Eligible participants were 326 children recruited from 6 socio-economically diverse areas in Melbourne, Australia, who took part in an earlier randomised trial for sleep problems at age 7 months. At 6 years, they participated in a follow-up assessment.
RESULTS:  HbA1c collected by finger-prick. Exposures (collected simultaneously): proxy measures of child stress including: (i) child mental health; (ii) maternal mental health (depression, anxiety, stress), negative life events in the preceding year, life stresses and coping; and (iii) family socioeconomic status and financial stress.
METHODS: linear regressions, adjusted for original randomisation status and clustering.
RESULTS: Sixty percent (134/225) of children retained at 6 years provided HbA1c data, which ranged from 3.9%-5.8% (SD 0.3%). No child or family variable was associated with HbA1c. Of the maternal variables, only anxiety predicted HbA1c (adjusted difference per point increase: -0.01, 95% CI: -0.003 to 0.02, P = 0.01); this association was in the opposite direction to that hypothesised and clinically insignificant.
CONCLUSIONS: HbA1c was not associated with psychosocial stress in healthy 6-year-olds. This suggests that any link between HbA1c and psychosocial stress emerges after this age, and that HbA1c is unlikely to be a reliable biomarker for stress in early childhood or over the transition to school.

BACKGROUND: Genes for thalassaemia, haemoglobin S, Glucose-6-phosphate dehydrogenase which confer resistance to malaria are found in high frequencies in Nigeria, 25% of the population being carriers of the sickle cell trait while another 25% are hemizygous for the G6PD gene. The frequency of alpha thalassaemia is equally high among Nigerians but there is little information on beta thalassaemia in this population. A recent study however suggest a high prevalence of beta thalassaemia in the same population, hence the need for this study.
METHODS: Haemoglobin A(2) and HbF were determined in healthy adults who have haemoglobin A genotype by elution after electrophoresis and alkaline denaturation methods respectively.
RESULTS: The mean HbA(2) among the subjects was 3.3% (range 2.0-5.6%) while the mean HbF was 2.6% (range 0.4-8.8%). Twenty-six percent of the subjects had HbA(2) values higher than 3.9% while 86% had HbF values greater than 1%, twenty-four percent had elevated HbA(2) and HbF. The mean HbA(2) value was 2.7% among those with HbF <1%, 3.6% among those with HbF 1-3% and 3.1% among those with HbF >3%.
CONCLUSIONS: These findings confirm that the frequency of beta thalassaemia in western Nigeria is higher than previously thought and that many of the individuals studied may be silent carriers of the beta thalassaemia trait. Its presence may also have been masked by the high prevalence of alpha thalassaemia in the same environment. It is therefore important to consider beta thalassaemia trait as a differential diagnosis in patients who present with haemolytic anaemia in this environment.