Periodontitis and metabolic syndrome

Background + Aims

• Periodontitis, a severe inflammatory condition affecting gums and surrounding structures is a significant health concern for individuals with type 2 diabetes mellitus (T2DM).
• Gullah African Americans, a genetically distinct population from South Carolina, exhibit high rates of T2DM, obesity, and hypertension, making them a unique group for studying health outcomes.
• Metabolic syndrome (MetS), defined by criteria such as: abdominal obesity, hypertension, low HDL cholesterol, and high triglycerides, is linked to increased systemic inflammation, potentially exacerbating periodontitis severity.
• The study aimed to assess whether MetS and its components influence the extent of severe periodontitis in individuals with T2DM. The researchers hypothesised that MetS contributes additional risk to periodontitis beyond T2DM alone.

Materials + Methods

• Secondary data analysis of a cross-sectional study involving 283 Gullah African Americans with T2DM.
• Periodontitis severity was measured by tooth sites with:
  • Clinical attachment level (CAL ≥6 mm)
  • Periodontal probing depth (PPD ≥5 mm).
• MetS was determined based on the National Cholesterol Education Program Adult Treatment Panel III, requiring the presence of at ≥3 criteria:
  • Abdominal obesity
  • Hypertension
  • Low HDL cholesterol
  • High triglycerides
  • High fasting glucose
• Trained examiners evaluated periodontal conditions, while participants’ social, medical, and oral health behaviours were documented.
• Blood samples provided markers such as glycated haemoglobin (HbA1c) and CRP.
• Negative binomial regression was employed to explore associations between MetS, its components, and severe periodontitis, adjusting for confounders such as age, gender, smoking status, and CRP levels.

Results

• MetS significantly increased the risk of severe periodontitis (CAL ≥6 mm), with a rate ratio (RR) of 2.77 (p = 0.03).
• Marginal significance was noted for MetS’s impact on PPD ≥5 mm (RR = 2.18; p = 0.06).
• Individual MetS components like large waist circumference showed marginal associations with periodontitis severity.
• Elevated CRP levels were strongly linked to more extensive periodontitis, reinforcing the inflammatory connection between MetS and oral health.
• Gender differences emerged, with women showing lower risk compared to men.
• The findings underline the compounded impact of MetS and T2DM on periodontal health in this population.

Limitations