Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
J Periodontol. 2019 Jul;90(7):728-746. doi: 10.1002/JPER.18-0523. Epub 2019 Feb 20.
A close relationship has been reported between metabolic syndrome (MetS) and periodontitis. However, as there are only a few longitudinal studies, the association between MetS and periodontitis has not been fully elucidated. The aim of the present study was to investigate the relationships between periodontal conditions and internal changes in MetS components using a longitudinal analysis.
A total of 985 out of 2716 individuals who underwent systemic medical checkups in 2014 and 754 out of 2454 in 2016 received dental checkups including Community Periodontal Index. Of these, 390 individuals underwent medical and dental checkups in 2014 and 2016 and were included and reviewed.
Of the 390 individuals, the positive number of MetS components decreased in 62 individuals (15.9%) and increased in 104 (26.7%). A multivariate analysis identified sex (risk ratio (RR): 0.55, 95% confidence interval (CI): 0.37-0.82, P < 0.05), alcohol intake (RR:2.06, 95%CI:1.14-3.73, P < 0.05), and the mediation of glycemia (RR:6.45, 95%CI:1.45-27.9, P < 0.01) as significant influencing factors for MetS. The number of MetS components was higher in individuals with persistent or progressive periodontitis than in those with no/improved periodontitis (RR:1.75, 95%CI:1.14-2.70, P < 0.01)). Improvements in periodontitis had a significant positive impact on MetS components, including hypertension (RR:2.14, 95%CI:1.03-4.43, P < 0.05) and hyperglycemia (RR:2.52, 95%CI:1.27-4.98, P < 0.01), but a negative impact on hypertension.
The results of the present study suggest that since the prevalence of individuals with more positive MetS components was higher in those with persistent/progressive periodontitis than in those with no/improved periodontitis, reducing periodontitis may be important for preventing pre-MetS and MetS.
代谢综合征(MetS)和牙周炎之间存在密切关系。然而,由于仅有少数纵向研究,因此代谢综合征和牙周炎之间的关联尚未完全阐明。本研究的目的是使用纵向分析来研究牙周状况与 MetS 成分的内部变化之间的关系。
在 2014 年接受系统体检的 2716 人中,共有 985 人接受了包括社区牙周指数在内的牙科检查。在 2016 年接受检查的 2454 人中,有 754 人接受了牙科检查。其中,390 人在 2014 年和 2016 年接受了医学和牙科检查,并进行了回顾性分析。
在 390 名个体中,MetS 成分阳性数量减少的有 62 人(15.9%),增加的有 104 人(26.7%)。多变量分析确定了性别(风险比(RR):0.55,95%置信区间(CI):0.37-0.82,P<0.05)、饮酒(RR:2.06,95%CI:1.14-3.73,P<0.05)和血糖的中介作用(RR:6.45,95%CI:1.45-27.9,P<0.01)是 MetS 的重要影响因素。与无/改善牙周炎相比,持续性或进行性牙周炎患者的 MetS 成分更高(RR:1.75,95%CI:1.14-2.70,P<0.01)。牙周炎的改善对 MetS 成分有显著的积极影响,包括高血压(RR:2.14,95%CI:1.03-4.43,P<0.05)和高血糖(RR:2.52,95%CI:1.27-4.98,P<0.01),但对高血压有负面影响。
本研究结果表明,由于持续性/进行性牙周炎患者中 MetS 成分阳性人数更多,因此降低牙周炎可能对预防前期 MetS 和 MetS 很重要。