title: Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey.
abstract: BACKGROUND
  Metabolic syndrome and periodontitis both have an increasing prevalence worldwide; however, limited information is available on their association.
  
  
  OBJECTIVE
  The objective of the study was to assess the association between periodontitis and the metabolic syndrome in a cross-sectional survey of a nationally representative sample of the noninstitutionalized civilians in the United States.
  
  
  METHODS
  Data analysis from the Third National Health and Nutrition Examination Survey on 13,994 men and women aged 17 yr or older who received periodontal examination were studied.
  
  
  METHODS
  Association of diagnosis and extent of periodontitis (gingival bleeding, probing pocket depths) with the metabolic syndrome and its individual component conditions (central obesity, hypertriglyceridemia, low high-density lipoprotein-cholesterol, hypertension, and insulin resistance) were measured. Adjustment for age, sex, years of education, poverty to income ratio, ethnicity, general conditions, and smoking were considered.
  
  
  RESULTS
  The prevalence of the metabolic syndrome was 18% [95% confidence interval (CI) 16-19], 34% (95% CI 29-38), and 37% (95% CI 28-48) among individuals with no-mild, moderate, and severe periodontitis, respectively. After adjusting for confounders, participants aged older than 45 yr suffering from severe periodontitis were 2.31 times (95% CI 1.13-4.73) more likely to have the metabolic syndrome than unaffected individuals. Diagnosis of metabolic syndrome increased by 1.12 times (95% CI 1.07-1.18) per 10% increase in gingival bleeding and 1.13 times (95% CI 1.03-1.24) per 10% increase in the proportion of periodontal pockets.
  
  
  CONCLUSIONS
  Severe periodontitis is associated with metabolic syndrome in middle-aged individuals. Further studies are required to test whether improvements in oral health lead to reductions in cardiometabolic traits and the risk of metabolic syndrome or vice versa.
authors.affiliation: UCL Eastman Dental Institute and Hospital, London WC1X 8LD, United Kingdom. f.daiuto@eastman.ucl.ac.uk
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Aiuto
authors.forename: Wael
authors.initials: W
authors.lastname: Sabbah
authors.forename: Gopalakrishnan
authors.initials: G
authors.lastname: Netuveli
authors.forename: Nikos
authors.initials: N
authors.lastname: Donos
authors.forename: Aroon D
authors.initials: AD
authors.lastname: Hingorani
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsakos
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D005884:Gingival Hemorrhage / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D011153:Population; D015995:Prevalence; D012107:Research Design; D014481:United States / Q000453:epidemiology