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Clinical Oral Investigations
Published in: Clinical Oral Investigations 6/2021

01-06-2021 | Obesity | Original Article

Moderate and severe periodontitis are positively associated with metabolic syndrome

Authors: Isaac Suzart Gomes-Filho, Izadora da S. C. E. Balinha, Simone S. da Cruz, Soraya C. Trindade, Eneida de M. M. Cerqueira, Johelle de S. Passos-Soares, Julita Maria F. Coelho, Ana Marice T. Ladeia, Maria Isabel P. Vianna, Alexandre M. Hintz, Teresinha C. de Santana, Pedro P. dos Santos, Ana Claúdia M. G. Figueiredo, Ivana C. O. da Silva, Frank A. Scannapieco, Maurício L. Barreto, Peter M. Loomer

Published in: Clinical Oral Investigations | Issue 6/2021

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Abstract

Objective

This study investigated the association between periodontitis severity (exposure) and metabolic syndrome (MetS - outcome), using two criteria for diagnosis of the outcome, since this relationship remains unexplored.

Materials and methods

A case-control study was conducted with 870 individuals: 408 with first MetS diagnosis (cases) and 462 without MetS (controls). Participants’ general information was obtained using a questionnaire and laboratory data was collected from medical records. Periodontitis severity criteria followed the Center for Disease Control and Prevention: none, mild, moderate, and severe. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by logistic regression analysis.

Results

Findings showed a positive association between moderate and severe periodontitis and MetS: ORadjusted = 1.64 (95% CI: 1.01 to 2.68) and ORadjusted = 1.94 (95% CI: 1.19 to 3.16), respectively, after adjustment for age, sex, schooling level, smoking habit, and cardiovascular disease. The adjusted measurements showed that among individuals with moderate or severe periodontitis, the probability of having MetS was around two times greater than among those without periodontitis, and that the chance was greater among participants with severe periodontitis than those with moderate periodontitis.

Conclusion

An association between the severity of periodontal status and MetS was found, suggesting a possible relationship between the two diseases.

Clinical relevance

MetS influences the etiology of cardiovascular diseases, one of the leading causes of mortality worldwide. The findings suggest that the greater the severity of periodontitis, the greater is the association magnitude with MetS. The health professional needs to recognize that the importance of periodontal disease may play in MetS.
Literature
1.
Dregan A et al (2014) Chronic inflammatory disorders and risk of type 2 diabetes mellitus, coronary heart disease, and stroke: a population-based cohort study. Circulation 130(10):837–844PubMed
2.
3.
Corrado E et al (2010) An update on the role of markers of inflammation in atherosclerosis. J Atheroscler Thromb 17(1):1–11PubMed
4.
Marcenes W et al (2013) Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res 92(7):592–597PubMedPubMedCentral
5.
Vos T et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2163–2196PubMedPubMedCentral
6.
Tonetti MS et al (2017) Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol 44(5):456–462PubMed
7.
Chen S et al (2014) Hyperlipidemia causes changes in inflammatory responses to periodontal pathogen challenge: implications in acute and chronic infections. Arch Oral Biol 59(10):1075–1084PubMed
8.
Schmitt A et al (2015) Periodontitis and arterial stiffness: a systematic review and meta-analysis. J Clin Periodontol 42(11):977–987PubMed
9.
Genco RJ et al (2005) A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 76(Suppl 11S):2075–2084PubMed
10.
Lin D et al (2003) Porphyromonas gingivalis infection in pregnant mice is associated with placental dissemination, an increase in the placental Th1/Th2 cytokine ratio, and fetal growth restriction. Infect Immun 71(9):5163–5168PubMedPubMedCentral
11.
Shoelson SE, Herrero L, Naaz A (2007) Obesity, inflammation, and insulin resistance. Gastroenterology 132(6):2169–2180PubMed
12.
Khosravi R et al (2013) Tumor necrosis factor-α and interleukin-6: potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediat Inflamm 2013:728987
13.
Borges P et al (2007) Prevalência e características associadas à síndrome metabólica em nipo-brasileiros com e sem doença periodontal. Cad Saúde Públ 23:657–668
14.
D’Aiuto F et al (2008) Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey. J Clin Endocrinol Metab 93(10):3989–3994PubMed
15.
Li P et al (2009) Relationship of metabolic syndrome to chronic periodontitis. J Periodontol 80(4):541–549PubMed
16.
Nesbitt MJ et al (2010) Association of periodontitis and metabolic syndrome in the Baltimore Longitudinal Study of Aging. Aging Clin Exp Res 22(3):238–242PubMedPubMedCentral
17.
Fukui N et al (2012) Periodontal status and metabolic syndrome in middle-aged Japanese. J Periodontol 83(11):1363–1371PubMed
18.
Gomes-Filho IS et al (2016) Severity of periodontitis and metabolic syndrome: is there an association? J Periodontol 87(4):357–366PubMed
19.
Pham T (2018) The association between periodontal disease severity and metabolic syndrome in Vietnamese patients. Int J Dent Hyg 16(4):484–491PubMed
20.
Kim OS et al (2018) The severity of periodontitis and metabolic syndrome in Korean population: the Dong-gu study. J Periodontal Res 53(3):362–368PubMed
21.
Caton JG et al (2018) A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification. J Periodontol. 2018 Jun;89 Suppl 1:S1-S8. J Clin Periodontol 45(S20)
22.
Page RC, Eke PI (2007) Case definitions for use in population-based surveillance of periodontitis. J Periodontol 78(7):1387–1399PubMed
23.
Eke PI et al (2012) Update of the case definitions for population-based surveillance of periodontitis. J Periodontol 83(12):1449–1454PubMedPubMedCentral
24.
Alberti KG et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120(16):1640–1645PubMed
25.
Grundy SM et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752PubMed
26.
Gorman A et al (2012) Changes in body weight and adiposity predict periodontitis progression in men. J Dent Res 91(10):921–926PubMedPubMedCentral
27.
Chan DC et al (2003) Waist circumference, waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men. QJM 96(6):441–447PubMed
28.
Andrade JP (2010) VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol 95:1–51
29.
Ramfjord SP (1959) Indices for prevalence and incidence of periodontal disease. J Periodontol 30(1):51–59
30.
Pihlstrom BL, Ortiz-Campos C, Mchugh RB (1981) A randomized four-years study of periodontal therapy. J Periodontol 52(5):227–242PubMed
31.
Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25(4):229–235PubMed
32.
López NJ, Smith PC, Gutierrez J (2002) Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol 73(8):911–924PubMed
33.
(IDF), I.D.F. The Internacional Diabetes Federation consensus worldwide definition of metabolic syndrome. 2005 [cited 2016 10 February]
34.
Nibali L et al (2013) Clinical review: association between metabolic syndrome and periodontitis: a systematic review and meta-analysis. J Clin Endocrinol Metab 98(3):913–920PubMed
35.
Rothman KJ, Greeland S, Lash TL (2011) Modern epidemiology, 3rd edn. Artmed, Porto Alegre, p 888
36.
Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287(3):356–359PubMed
37.
Razzouk L, Muntner P (2009) Ethnic, gender, and age-related differences in patients with the metabolic syndrome. Curr Hypertens Rep 11(2):127–132PubMed
38.
Duane B (2014) Further evidence that periodontal bone loss increases with smoking and age. Evid Based Dent 15(3):72–73PubMed
39.
Lee JA et al (2017) Impact of combined lifestyle factors on metabolic syndrome in Korean men. J Public Health (Oxf) 39(1):82–89
40.
Kurl S et al (2016) Metabolic syndrome and the risk of sudden cardiac death in middle-aged men. Int J Cardiol 203:792–797PubMed
41.
Stewart R, West M (2016) Increasing evidence for an association between periodontitis and cardiovascular disease. Circulation 133(6):549–551PubMed
42.
Lee WY et al (2005) Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the ATP III. Diabetes Res Clin Pract 67(1):70–77PubMed
43.
Metadata
Title
Moderate and severe periodontitis are positively associated with metabolic syndrome
Authors
Isaac Suzart Gomes-Filho
Izadora da S. C. E. Balinha
Simone S. da Cruz
Soraya C. Trindade
Eneida de M. M. Cerqueira
Johelle de S. Passos-Soares
Julita Maria F. Coelho
Ana Marice T. Ladeia
Maria Isabel P. Vianna
Alexandre M. Hintz
Teresinha C. de Santana
Pedro P. dos Santos
Ana Claúdia M. G. Figueiredo
Ivana C. O. da Silva
Frank A. Scannapieco
Maurício L. Barreto
Peter M. Loomer
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Keywords
Obesity
Obesity
Published in
Clinical Oral Investigations / Issue 6/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-020-03699-2

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