Association between metabolic syndrome and periodontitis: a systematic review and meta-analysis

Abstract

The aim of the present study was to evaluate the association between metabolic syndrome (MS) and periodontitis (PD), through a systematic review and meta-analysis. Original observational studies assessing the association between MS and PD in adults, published before May 11th (2017), were identified through electronic searches of MEDLINE, EMBASE and Cochrane Library databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. For studies to be included, they had to mention the criteria used to diagnose MS and to have used at least one clinical measure to diagnose PD. There was no language restriction. Three reviewers independently identified eligible studies for possible inclusion in the systematic review and meta-analysis. The quality of the studies was evaluated by the Newcastle-Ottawa scale for observational studies. A random model meta-analysis was conducted. The strategies used to investigate heterogeneity were sequential analysis, subgroup analysis, univariate meta-regression and sensitivity analysis. Thirty-three studies met the inclusion criteria for the systematic review, and 26 had enough information to be included in the meta-analysis, totaling 52,504 patients. MS and PD were associated with an odds ratio of 1.38 (95%CI 1.26-1.51; I2 = 92.7%; p < 0.001). Subgroup analysis showed that complete periodontal examination (I2 = 70.6%; p < 0.001) partially explained the variability between studies. The present findings suggest an association between MS and PD. Individuals with MS are 38% more likely to present PD than individuals without this condition. Prospective studies should be conducted to establish cause and effect relations between MS and PD.

Risk of complications among diabetics self-reporting oral health status in Canada: A population-based cohort study

“…Notably, these markers are found at lower concentrations among healthy individuals (35). This supports the concept that periodontal disease is an independent factor in the progression of systemic grade inflammation.…”

“…Recent studies have hypothesized that as periodontal disease manifests itself as low grade chronic inflammatory condition, it has the potential to contribute to the generation of a systemic inflammatory phenotype (34). This hypothesis is consistent with evidence demonstrating that individuals with periodontal disease present with elevated markers of inflammation (4,35).…”

Risk of complications among diabetics self-reporting oral health status in Canada: A population-based cohort study

“…This hypothesis is consistent with evidence demonstrating that individuals with periodontal disease have higher markers of inflammation [4,36]. Notably, these markers are found at lower concentrations among healthy individuals [36]. This supports the concept that periodontal disease contributes independently to systemic inflammation.…”

“…"Good to Excellent" (n = 4090) "Poor to Fair" (n = 1093) Recent studies have hypothesized that, because periodontal disease manifests as a low grade chronic inflammatory condition, it has the potential to contribute to the generation of a systemic inflammatory phenotype [35]. This hypothesis is consistent with evidence demonstrating that individuals with periodontal disease have higher markers of inflammation [4,36]. Notably, these markers are found at lower concentrations among healthy individuals [36].…”

Epigenetic and inflammatory events in experimental periodontitis following systemic microbial challenge

“…Periodontal disease is a multifactorial chronic immuno‐inflammatory disease, where both the protective and supportive tissues of the periodontium are affected. The disease is not just confined to the oral cavity but has been strongly associated with other systemic chronic inflammatory conditions, such as metabolic syndrome (Daudt et al, ; Hajishengallis, ; Lamster & Pagan, ) and diabetes (Miguel‐Infante et al, ), cardiovascular disease (Lockhart et al, ; Tonetti & Van Dyke, ) and Alzheimer's disease (Olsen & Singhrao, ), with varying degrees of causal corroboration. In contrast to the previous paradigm where attention was on the microbial composition of the periodontal biofilm, the host response is now being recognized as the major contributor driving the development of chronic periodontal destruction.…”