title: Metabolic Syndrome and Periodontal Disease Progression in Men.
abstract: Metabolic syndrome, a cluster of 3 or more risk factors for cardiovascular disease, is associated with periodontal disease, but few studies have been prospective in design. This study's aim was to determine whether metabolic syndrome predicts tooth loss and worsening of periodontal disease in a cohort of 760 men in the Department of Veterans Affairs Dental Longitudinal Study and Normative Aging Study who were followed up to 33 y from 1981 to 2013. Systolic and diastolic blood pressures were measured with a standard mercury sphygmomanometer. Waist circumference was measured in units of 0.1 cm following a normal expiration. Fasting blood samples were measured in duplicate for glucose, triglyceride, and high-density lipoprotein. Calibrated periodontists served as dental examiners. Periodontal outcome events on each tooth were defined as progression to predefined threshold levels of probing pocket depth (≥5 mm), clinical attachment loss (≥5 mm), mobility (≥0.5 mm), and alveolar bone loss (≥40% of the distance from the cementoenamel junction to the root apex, on radiographs). Hazards ratios (95% confidence intervals) of tooth loss or a periodontitis event were estimated from tooth-level extended Cox proportional hazards regression models that accounted for clustering of teeth within individuals and used time-dependent status of metabolic syndrome. Covariates included age, education, smoking status, plaque level, and initial level of the appropriate periodontal disease measure. Metabolic syndrome as defined by the International Diabetes Federation increased the hazards of tooth loss (1.39; 1.08 to 1.79), pocket depth ≥5 mm (1.37; 1.14 to 1.65), clinical attachment loss ≥5 mm (1.19; 1.00 to 1.41), alveolar bone loss ≥40% (1.25; 1.00 to 1.56), and tooth mobility ≥0.5 mm (1.43; 1.07 to 1.89). The number of positive metabolic syndrome conditions was also associated with each of these outcomes. These findings suggest that the metabolic disturbances that comprise the metabolic syndrome may play a role in the development or worsening of periodontitis.
authors.affiliation: Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA kralle@bu.edu.
authors.forename: E K
authors.initials: EK
authors.lastname: Kaye
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: H J
authors.initials: HJ
authors.lastname: Cabral
authors.affiliation: Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA Division of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Vokonas
authors.affiliation: Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: R I
authors.initials: RI
authors.lastname: Garcia
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D018450:Disease Progression; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D010510:Periodontal Diseases / Q000209:etiology*; D010514:Periodontal Pocket / Q000209:etiology; D016016:Proportional Hazards Models; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: Metabolic Syndrome X; bone loss; epidemiology; periodontitis; risk factors; systemic health/disease