Periodontal Diseases and the Risk of Metabolic Syndrome: An Updated Systematic Review and Meta-Analysis

Abstract

Background: Periodontitis and metabolic syndrome (MetS) are two major global health problems that are widely prevalent in the world, although the former is a common infection in developing countries and the latter is a non-infectious but prevalent disease in developed countries. This study aims to provide an updated review on the existence and magnitude of the relationship between periodontal disease and the risk of MetS. Methods: We searched the PubMed, Web of Science, ScienceDirect, Chinese National Knowledge Infrastructure, and Wanfang databases for original studies assessing the association between periodontitis and MetS published before August 2019. We calculated the pooled crude and adjusted odds ratios (ORs) together with the 95% confidence intervals (95% CIs) to estimate the strength of this association. Subgroup analysis was performed by considering the diagnostic method or the country where the studies were performed. Results: We identified 43 potentially eligible articles for this systematic review, including 32 cross-sectional studies, eight case-control studies, and three cohort studies. Among them, 39 articles presented enough information to be included in the meta-analysis. The pooled crude and adjusted ORs were 1.99 (95% CI: 1.75-2.25) and 1.46 (95% CI: 1.31-1.61), respectively. Subgroup analysis showed a consistent relation stratified by either the diagnostic method or the country where the studies were performed. The pooled OR was 1.68 (95% CI: 1.41-2.00) for Japan, 1.75 (95% CI: 1.31-2.34) for the USA, 1.81 (95% CI: 1.35-2.42) for Korea, and 2.29 (95% CI: 1.53-3.41) for China. Conclusion: Our results provide compelling evidence for the association between periodontitis and MetS. Patients with periodontal disease are a critical screening population for MetS. We also recommend that people exhibiting components of MetS should receive a periodontal checkup and pay attention to their oral health.

Relationship between periodontal diseases and newly-diagnosed metabolic syndrome components in a sub-Saharan population: a cross sectional study

“…This highlights a two-way relationship between both pathologies and can be explained by a cause-effect relationship underlined by chronic low-grade inflammation common to periodontal disease and the components of metabolic syndrome we cited above. Inflammatory markers involved in metabolic syndrome (TNF-α, IL-1, IL-6, PAI-1) can upregulate periodontal disease when a persistent periodontal inflammation can exacerbate systemic inflammation, insulin resistance and endothelial dysfunction [ 33 ].…”

Early identification of metabolic syndrome risk: A review of reviews and proposal for defining pre-metabolic syndrome status

“…Periodontitis (PD) has also been proposed as a comorbidity associated with MetSyn. Indeed, a meta-analysis revealed a positive association between MetSyn and PD and suggested that individuals with MetSyn are 38% more likely to have PD than individuals without MetSyn [45,46]. Accordingly, Muñoz-Aguilera et al (2020) observed a positive association between hypertension and periodontitis leading to an increase in the risk of high systolic and diastolic blood pressure and hypertension [47].…”

Does Last Year’s Cost Predict the Present Cost? An Application of Machine Leaning for the Japanese Area-Basis Public Health Insurance Database

“…The most frequent disease leading to death worldwide is a non-communicable disease. Oral health, especially the periodontal condition has been suggested to be affected by noncommunicable diseases [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. An imbalance towards a periodontal immune response is underlined for other chronic diseases [ 11 ].…”

“…An imbalance towards a periodontal immune response is underlined for other chronic diseases [ 11 ]. Epidemiological studies had shown that periodontitis was associated with the metabolic syndrome [ 3 ] and cardiovascular disease [ 4 , 7 ]. The suboptimal oral function was a potential risk of mortality [ 12 , 13 ].…”