title: Metabolic syndrome, insulin resistance, and periodontitis: a cross-sectional study in a middle-aged French population.
abstract: OBJECTIVE
  Metabolic syndrome consists of a cluster of clinical and biological abnormalities, influenced by insulin resistance and promoting cardiovascular diseases. We examined the relationships between metabolic syndrome, its various components, insulin resistance, and periodontitis.
  
  
  METHODS
  The study included 276 subjects (35-74 years) recruited within a cross-sectional survey on cardiovascular risk factors. Twenty-one were excluded because of infectious risk or total tooth loss. Clinical attachment loss (CAL), probing pocket depth (PD), gingival and plaque indexes were recorded. Periodontitis was classified into moderate and severe forms.
  
  
  RESULTS
  The mean age was 58, 41% of the subjects had moderate and 39% had severe periodontitis. In univariate comparisons, periodontitis was associated with metabolic syndrome (p=0.050), most of its components, and HOMA index (homoeostasis model assessment of insulin resistance). After adjustment for confounders, only HOMA index remained associated with severe periodontitis (odds ratio [OR]=3.97 [95% confidence interval: 1.22-12.9], OR=3.78 [1.14-12.5] for third and fourth versus the first quartile of the HOMA index, respectively). The HOMA index was also associated with the number of periodontal sites with CAL>or=4 mm, CAL>or=5 mm, or PD>or=4 mm (greater number for higher HOMA-index values). This relationship disappeared in never-smokers.
  
  
  CONCLUSIONS
  Our data support the relationships between metabolic disturbances and periodontitis, with a central role of insulin resistance.
authors.affiliation: INSERM U558, Centre Hospitalier Universitaire de Toulouse, Université de Toulouse, Toulouse, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Benguigui
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.forename: Bernard
authors.initials: B
authors.lastname: Chamontin
authors.forename: Michel
authors.initials: M
authors.lastname: Sixou
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.forename: Jacques
authors.initials: J
authors.lastname: Amar
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D006973:Hypertension / Q000150:complications; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications; D017622:Periodontal Attachment Loss / Q000150:complications; D010518:Periodontitis / Q000150:complications* / Q000503:physiopathology; D016012:Poisson Distribution; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires
chemical_list: D008055:Lipids