The severity of periodontitis and metabolic syndrome in Korean population: The Dong‐gu study

OBJECTIVES We assessed the association between periodontal disease status and metabolic syndrome (MetS) and its individual components in Korean adults over 50 years old. MATERIAL AND METHODS In the Dong-gu study, 5078 men and women aged over 50 years were included. They underwent a questionnaire survey, physical assessment, biochemical assessment and periodontal assessment. The percentages of sites with periodontal probing depth ≥4 mm, and clinical attachment loss ≥4 mm were recorded for each participant. Periodontal disease was also classified by the Centers for Disease Control and Prevention/American Academy of Periodontology definition of periodontitis and the American Academy of Periodontology definition (1999). MetS was defined by the 2009 guidelines of the International Diabetes Federation. This study used multivariate negative binominal regression analysis to assess the association between the severity of periodontitis and MetS, after age, smoking habits, alcohol consumption and physical activity related factors were adjusted for. RESULTS Prevalence of MetS was 32.3%, 36.2% and 45.9% among men with no or mild, moderate and severe periodontitis, respectively. The severity of periodontitis was positively associated with the prevalent MetS in men but not in women. In men, severe periodontitis showed a higher risk of MetS than those with no or mild periodontitis (relative risk 1.43, 95% confidence interval 1.17-1.73) after adjusting for confounders. Periodontal probing depth was positively associated with the prevalence of MetS in both genders. In the analysis separated by individual MetS components, periodontitis severity was positively associated with hypertriglyceridemia and low high-density lipoprotein cholesterol in men, while positively associated with low high-density lipoprotein cholesterol and abdominal obesity in women. CONCLUSION Increasing the severity of periodontitis was associated with the risk of prevalent MetS in Korean adults. This result confirmed that periodontal inflammation might be a contributive factor of MetS.

[1]  Su-yeon Kim,et al.  Associations between Metabolic Syndrome and Inadequate Sleep Duration and Skipping Breakfast , 2015, Korean journal of family medicine.

[2]  Kyungdo Han,et al.  Associations Among Oral Hygiene Behavior and Hypertension Prevalence and Control: The 2008 to 2010 Korea National Health and Nutrition Examination Survey. , 2015, Journal of periodontology.

[3]  Y. Izumi,et al.  Association of untreated metabolic syndrome with moderate to severe periodontitis in Thai population. , 2014, Journal of periodontology.

[4]  R. Browne,et al.  Association between metabolic syndrome and periodontal disease measures in postmenopausal women: the Buffalo OsteoPerio study. , 2014, Journal of periodontology.

[5]  Keiko Watanabe,et al.  Periodontal disease and metabolic syndrome: a qualitative critical review of their association. , 2014, Archives of oral biology.

[6]  M. Jimenez,et al.  Associations between measures of central adiposity and periodontitis among older adults. , 2014, Community dentistry and oral epidemiology.

[7]  H. Nam,et al.  COHORT PROFILE Cohort Profile : The Namwon Study and the Dong-gu Study , 2014 .

[8]  Xianglin L. Du,et al.  Assessing periodontitis in populations: a systematic review of the validity of partial-mouth examination protocols. , 2013, Journal of clinical periodontology.

[9]  W. Borgnakke,et al.  Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. , 2013, Journal of clinical periodontology.

[10]  Y. Shimazaki,et al.  Periodontal status and metabolic syndrome in middle-aged Japanese. , 2012, Journal of periodontology.

[11]  B. Lu,et al.  Prospective association of periodontal disease with cardiovascular and all-cause mortality: NHANES III follow-up study. , 2011, Atherosclerosis.

[12]  G. Liguori,et al.  Persistent Increase of Prevalence of Metabolic Syndrome Among U.S. Adults: NHANES III to NHANES 1999–2006 , 2010, Diabetes Care.

[13]  R. Dunford,et al.  Association between metabolic syndrome and periodontal disease. , 2010, Australian dental journal.

[14]  Luigi Ferrucci,et al.  Association of periodontitis and metabolic syndrome in the Baltimore Longitudinal Study of Aging , 2010, Aging clinical and experimental research.

[15]  K. Takada,et al.  A cohort study on the association between periodontal disease and the development of metabolic syndrome. , 2010, Journal of periodontology.

[16]  S. Grundy,et al.  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 As , 2009, Circulation.

[17]  Georgios Tsakos,et al.  Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey. , 2008, The Journal of clinical endocrinology and metabolism.

[18]  P. Eke,et al.  Case Definitions for Use in Population-Based Surveillance of Periodontitis. , 2007, Journal of periodontology.

[19]  Y. Kiyohara,et al.  Relationship of Metabolic Syndrome to Periodontal Disease in Japanese Women: The Hisayama Study , 2007, Journal of dental research.

[20]  R. D'Agostino,et al.  Metabolic Syndrome as a Precursor of Cardiovascular Disease and Type 2 Diabetes Mellitus , 2005, Circulation.

[21]  P. Petersen,et al.  Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. , 2005, Community dentistry and oral epidemiology.

[22]  Jane B Shofer,et al.  Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. , 2004, Diabetes.

[23]  Y. Kiyohara,et al.  The Severity of Periodontal Disease is Associated with the Development of Glucose Intolerance in Non-diabetics: The Hisayama Study , 2004, Journal of dental research.

[24]  G. Armitage,et al.  Development of a classification system for periodontal diseases and conditions. , 1999, Annals of periodontology.

[25]  A. Marcus,et al.  Vascular transcellular signaling. , 1993, Journal of lipid research.

[26]  A. V. van Winkelhoff,et al.  Infection and inflammatory mechanisms. , 2013, Journal of periodontology.

[27]  D. Paek,et al.  Periodontitis could be related factors on metabolic syndrome among Koreans: a case-control study. , 2012, Journal of clinical periodontology.