D'Aiuto F et al. (2008) Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey. J Clin Endocrinol Metab 93: 3989–3994

Periodontitis has been associated with several components of the metabolic syndrome, such as systemic inflammation, increased insulin resistance and an increased risk of type 2 diabetes, and an almost 20% increased risk of cardiovascular disease. Little information is available, however, on the possible link between the metabolic syndrome and periodontitis. To investigate the possible association, D'Aiuto and colleagues analyzed a cross-sectional survey of noninstitutionalized individuals.

The researchers examined data derived from the Third National Health and Nutrition Examination Survey (NHANES III) on 13,710 individuals aged ≥17 years who had undergone periodontal assessment. Binary (diagnosis) and continuous (clinical extent) measures of periodontitis were considered in relation to the metabolic syndrome and its individual component conditions (central obesity, insulin resistance, elevated triglycerides, low HDL-cholesterol, and hypertension). Prevalence of the metabolic syndrome increased in a linear fashion according to the severity of periodontitis: 18%, 34% and 37% for no or mild periodontitis, moderate periodontitis and severe periodontitis, respectively. Further analysis and adjustment for confounding factors revealed that in never smokers aged over 45 years, those with severe periodontitis were 2.31 times more likely to have the metabolic syndrome than individuals with mild or no periodontitis.

D'Aiuto et al. suggest that their findings might explain previous reports of a link between periodontitis and an increased risk of vascular disease and diabetes mellitus later in life. The authors recommend further studies powered to investigate whether improvements in oral health can reduce the risk of the metabolic syndrome and associated traits.