Association of Untreated Metabolic Syndrome With Moderate to Severe Periodontitis in Thai Population
- Autores: Supanee Thanakun, Hisashi Watanabe, Sroisiri Thaweboon, Yuichi Izumi
- Localización: Journal of periodontology, ISSN 0022-3492, Vol. 85, Nº. 11, 2014, págs. 1502-1514
- Idioma: inglés
- Enlaces
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Resumen
Background: Metabolic syndrome (MetS) correlates with systemic inflammation. A relation of MetS to periodontitis has been reported. This study aims to evaluate whether periodontitis is associated with untreated MetS, plasma adiponectin, and leptin among Thai people.
Methods: One hundred twenty-five participants (aged 35 to 76 years) were recruited. Demographic and biologic data, bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) of all teeth were examined. Plasma adiponectin and leptin levels were measured.
Results: Forty-four participants (35.2%) were healthy, and 81 (64.8%) had MetS. All periodontal conditions (BOP, PD, and CAL) were significantly worse in patients with MetS than healthy participants. After adjustment for confounders, MetS was strongly associated with severe periodontitis (odds ratio [OR] = 3.60, 95% confidence interval [CI]: 1.34 to 9.65). MetS with four to five components had a higher association with periodontitis than did MetS with three components (OR = 5.49, 95% CI: 1.75 to 17.19), whereas each separate component had no association with periodontitis, except for high diastolic blood pressure. Periodontitis was also associated with age (OR = 1.08, 95% CI: 1.01 to 1.14) and education (OR = 3.76, 95% CI: 1.05 to 13.40). The risk of MetS was predicted by body mass index and plasma adiponectin (OR = 1.90, 95% CI: 1.24 to 2.92 and OR = 0.93, 95% CI: 0.88 to 0.98, respectively).
Conclusions: There may be a relationship between untreated MetS and periodontitis in Thai people. Periodontal diagnosis should be regularly conducted in patients with MetS.
Metabolic syndrome (MetS) is a state of metabolic dysregulation and predisposes individuals to cardiovascular disease (CVD), stroke, and diabetes mellitus (DM).1 MetS is diagnosed when at least three of the following five components are present: central obesity, high fasting plasma glucose (FPG), high triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL-C) levels, and hypertension.2 The number of patients with MetS is globally increasing. The prevalence of Thai patients with MetS is ≈15%, which is similar to that in developed countries.3-6 Periodontitis has been reported to be associated with a range of systemic diseases, including the final stages of MetS, CVD, and DM.7,8 Evidence for a relationship between MetS and periodontitis has been reported in many populations.9-13 Patients affected by MetS are twice as likely to have periodontitis compared with a healthy population.14 The underlying biologic mechanisms for the association of MetS with periodontitis are not well known; however, adipose tissue–derived cytokines may play an important role.15 Visceral adipose tissue secretes a variety of bioactive substances termed adipocytokines, such as adiponectin, leptin, resistin, tumor necrosis factor-α, interleukin (IL)-1, IL-6, IL-8, C-reactive protein (CRP), angiotensin II, and plasminogen activator inhibitor 1, which induce insulin resistance (IR) and thrombogenic vascular diseases.15 These adipocytokines are most prevalent in the inflammatory response.15 They affect the entire body and contribute to low-grade systemic and vascular inflammation.16 This results in patients with MetS being more at risk for the effects of microbial plaques,16 which in turn may modulate the severity of periodontitis.15 This study aims to test the hypothesis that Thai patients with untreated MetS have increased periodontal inflammation and clinical attachment level (CAL).
