Association between periodontitis and metabolic syndrome in the Hamburg City Health Study.
chronic periodontitis
cross-sectional studies
dental plaque
energy intake
exercise
logistic models
metabolic syndrome
smoking
Journal
Journal of periodontology
ISSN: 1943-3670
Titre abrégé: J Periodontol
Pays: United States
ID NLM: 8000345
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
26
11
2021
received:
05
08
2021
accepted:
29
11
2021
pubmed:
31
12
2021
medline:
19
8
2022
entrez:
30
12
2021
Statut:
ppublish
Résumé
Previous studies demonstrated an association between severe chronic periodontitis (CP) and metabolic syndrome (MetS). However, these studies mostly used the outdated National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III case definition of MetS. Additionally, CP was rarely diagnosed based on a full-mouth examination. Thus, the aim of the current study was to re-evaluate the potential association between CP and MetS in the Hamburg City Health Study (HCHS), a large population-based survey of middle-aged and elderly men and women in Germany, in view of more current definitions of MetS and CP. A cross-sectional study was performed with baseline-data from participants of the HCHS. Periodontitis severity grades were determined in a random sample of 6,209 participants of which 5,456 had sufficient data to call absence or presence of MetS. Variables defining MetS according to the currently valid harmonized definition were determined and a full-mouth examination was performed, including determination of the clinical attachment loss, bleeding on probing, and dental plaque index. CP was classified in three grades of severity (none/mild, moderate, and severe). The Kruskal-Wallis test or the Chi-squared test were used for descriptive statistics and multivariate logistic regression models with and without adjustments for potential confounders (age, sex, smoking, high-sensitivity C-reactive protein [hsCRP], energy intake, and physical activity) were used to test for associations. The prevalence of MetS (39.0%) increased according to the severity grades of periodontitis (none/mild: 33.6%; moderate: 38.7%, and severe: 46.8%). Multivariate logistic regression analyses demonstrated that severe but not moderate CP was associated with MetS after adjusting for age and sex (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.03 to 1.48; P = 0.02). However, the association was attenuated after additional adjustment for smoking (OR, 1.19; 95% CI, 0.99 to 1.43; P = 0.058) and hsCRP, energy intake, and physical activity (OR, 1.11; 95% CI, 0.91 to 1.36; P = 0.294). The use of the more current definitions for MetS and CP confirmed previous observations of an age- and sex-adjusted association between severe CP and MetS. Smoking, high-energy intake, and low physical activity were identified as important lifestyle-related confounders. Abdominal obesity, as indicated by elevated waist circumference, was determined as the most important component of MetS in relationship to CP.
Sections du résumé
BACKGROUND
Previous studies demonstrated an association between severe chronic periodontitis (CP) and metabolic syndrome (MetS). However, these studies mostly used the outdated National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III case definition of MetS. Additionally, CP was rarely diagnosed based on a full-mouth examination. Thus, the aim of the current study was to re-evaluate the potential association between CP and MetS in the Hamburg City Health Study (HCHS), a large population-based survey of middle-aged and elderly men and women in Germany, in view of more current definitions of MetS and CP.
METHODS
A cross-sectional study was performed with baseline-data from participants of the HCHS. Periodontitis severity grades were determined in a random sample of 6,209 participants of which 5,456 had sufficient data to call absence or presence of MetS. Variables defining MetS according to the currently valid harmonized definition were determined and a full-mouth examination was performed, including determination of the clinical attachment loss, bleeding on probing, and dental plaque index. CP was classified in three grades of severity (none/mild, moderate, and severe). The Kruskal-Wallis test or the Chi-squared test were used for descriptive statistics and multivariate logistic regression models with and without adjustments for potential confounders (age, sex, smoking, high-sensitivity C-reactive protein [hsCRP], energy intake, and physical activity) were used to test for associations.
RESULTS
The prevalence of MetS (39.0%) increased according to the severity grades of periodontitis (none/mild: 33.6%; moderate: 38.7%, and severe: 46.8%). Multivariate logistic regression analyses demonstrated that severe but not moderate CP was associated with MetS after adjusting for age and sex (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.03 to 1.48; P = 0.02). However, the association was attenuated after additional adjustment for smoking (OR, 1.19; 95% CI, 0.99 to 1.43; P = 0.058) and hsCRP, energy intake, and physical activity (OR, 1.11; 95% CI, 0.91 to 1.36; P = 0.294).
CONCLUSIONS
The use of the more current definitions for MetS and CP confirmed previous observations of an age- and sex-adjusted association between severe CP and MetS. Smoking, high-energy intake, and low physical activity were identified as important lifestyle-related confounders. Abdominal obesity, as indicated by elevated waist circumference, was determined as the most important component of MetS in relationship to CP.
Identifiants
pubmed: 34967009
doi: 10.1002/JPER.21-0464
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1150-1160Informations de copyright
© 2022 The Authors. Journal of Periodontology published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.
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