Association of the Metabolic Syndrome with Severe Periodontitis

Objectives: Metabolic syndrome and periodontal disease both have an increasing prevalence worldwide. Limited information, however is available on the association between periodontal disease and metabolic syndrome. The aim of this analysis was to assess the association between these two disorders in a cross-sectional survey of a nationally representative sample of the non-institutionalized civilians in the United States.

Methods: Data was retrieved from the Third National Health and Nutrition Examination Survey on 13994 men and women aged 17 years or older who received a periodontal examination. Association of diagnosis (no-mild, moderate or severe) and severity/extent of periodontitis (gingival bleeding, probing depths and attachment loss) with the metabolic syndrome and its individual component conditions (central obesity, hypertriglyceridemia, low HDL-cholesterol, hypertension, and insulin resistance) was assessed controlling for age, sex, years of education, poverty-income ratio, ethnicity, general conditions and cigarettes smoking.

Results: The prevalence of the metabolic syndrome in individuals with no or mild versus severe periodontitis was 18% (95%CI 16-19) and 37% (95%CI 28-48) respectively (p<0.001). After adjusting for confounders, adult participants (>45 years) suffering from severe periodontitis were 1.74 times (95%CI 1.10-2.76) more likely to have the metabolic syndrome than individuals with no or mild periodontitis. Diagnosis of metabolic syndrome increased by 1.12 times (95%CI 1.07-1.18) per 10% increase in full mouth gingival bleeding and by 1.13 times (95%CI 1.03-1.24) per 10% increase in the proportion of gingival pockets greater than 4 mm.

Conclusions: Severe periodontitis is associated with the metabolic syndrome in middle aged individuals. Further studies are needed to ascertain the exact nature of this association.