Metabolic Syndrome and Periodontal Disease Progression in Men

Abstract

Metabolic syndrome, a cluster of 3 or more risk factors for cardiovascular disease, is associated with periodontal disease, but few studies have been prospective in design. This study's aim was to determine whether metabolic syndrome predicts tooth loss and worsening of periodontal disease in a cohort of 760 men in the Department of Veterans Affairs Dental Longitudinal Study and Normative Aging Study who were followed up to 33 y from 1981 to 2013. Systolic and diastolic blood pressures were measured with a standard mercury sphygmomanometer. Waist circumference was measured in units of 0.1 cm following a normal expiration. Fasting blood samples were measured in duplicate for glucose, triglyceride, and high-density lipoprotein. Calibrated periodontists served as dental examiners. Periodontal outcome events on each tooth were defined as progression to predefined threshold levels of probing pocket depth (≥5 mm), clinical attachment loss (≥5 mm), mobility (≥0.5 mm), and alveolar bone loss (≥40% of the distance from the cementoenamel junction to the root apex, on radiographs). Hazards ratios (95% confidence intervals) of tooth loss or a periodontitis event were estimated from tooth-level extended Cox proportional hazards regression models that accounted for clustering of teeth within individuals and used time-dependent status of metabolic syndrome. Covariates included age, education, smoking status, plaque level, and initial level of the appropriate periodontal disease measure. Metabolic syndrome as defined by the International Diabetes Federation increased the hazards of tooth loss (1.39; 1.08 to 1.79), pocket depth ≥5 mm (1.37; 1.14 to 1.65), clinical attachment loss ≥5 mm (1.19; 1.00 to 1.41), alveolar bone loss ≥40% (1.25; 1.00 to 1.56), and tooth mobility ≥0.5 mm (1.43; 1.07 to 1.89). The number of positive metabolic syndrome conditions was also associated with each of these outcomes. These findings suggest that the metabolic disturbances that comprise the metabolic syndrome may play a role in the development or worsening of periodontitis.

Defining the gut microbiota in individuals with periodontal diseases: an exploratory study

“…Among those, periodontal diseases are complex polymicrobial inflammatory diseases associated with dysbiosis of the dental biofilm that induces a long-lasting chronic inflammation of the periodontal supporting tissues, leading to alveolar bone destruction, and eventual tooth loss [6]. Over the years, strong evidence has accumulated to indicate that the pathogenic microbiota and the chronic inflammation established in periodontitis contribute to the onset and/or progression of several systemic inflammatory diseases such as cardiovascular diseases [7,8], diabetes [9], obesity [10], metabolic syndrome [11], respiratory disease [12], cancer [13], chronic kidney disease (CKD) [14] and rheumatoid arthritis (RA) [15]. Most research on the periodontitis-systemic disease relationship, however, has not determined causality, and the link between these diseases are bi-directional associations [16].…”

Periodontal Disease And Its Impact on Health, From Cardiovascular Diseases to Metabolic Syndrome

“…This was demonstrated by high levels of C-reactive protein, tumour necrosis factor α (TNF-α) and interleukin 6 [15] . However, only waist circumference could be an accurate indicator of the distribution of abdominal fat and related to health problems [16]. The probability of having a periodontitis in an obese subject increases by 30% compared with a healthy subject, with more loss of clinical attachment in obese patients and a higher BMI in subjects with periodontitis [16,17].…”

“…However, only waist circumference could be an accurate indicator of the distribution of abdominal fat and related to health problems [16]. The probability of having a periodontitis in an obese subject increases by 30% compared with a healthy subject, with more loss of clinical attachment in obese patients and a higher BMI in subjects with periodontitis [16,17]. In France, the study by Benguigui et al in 2012, comprising 186 individuals, shows that the number of sites with a plaque index greater than 2 is significantly related to obesity.…”

“…The expression of these susceptibility genes can be influenced by epigenetic and environmental factors. Recently, some microRNAs (miRNAs) have been identified and are potentially susceptible to act on inflammatory processes [16].…”

“…Obesity can interfere with the ability of the immune system to respond appropriately to an infection induced in animals by one of the major periodontal pathogens, Porphyromonas gingivalis [16].…”