Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Clin Oral Investig. 2022 Sep;26(9):5557-5574. doi: 10.1007/s00784-022-04583-x. Epub 2022 Jun 18.
To evaluate the role of metabolic syndrome (MetS) components in the association with periodontitis (PE) (#CRD42020218310).
A systematic electronic search was performed in PUBMED, Scielo and Lilacs databases up to April 2022. Cross-sectional, case-control, and cohort studies presenting data on the association between MetS and PE in the adult and elderly populations were included. A random effect meta-analysis was performed to determine association effect estimates. Results interpretation followed the assessment of methodological quality (Joana Briggs Institute tool) together with the certainty of evidence (GRADE approach).
This review included 52 studies, totalling 140,434 participants, and 38 studies were meta-analyzed. Association between PE and MetS was observed (OR from 1.27 to 1.90; PR = 1.19; RR from 1.10 to 1.37) (low and very low certainty of evidence). Hyperglycaemia (OR = 1.18), HDL (OR = 1.16), obesity (OR = 1.08), and hypertension (OR = 1.11) were associated with PE, except triglycerides (low and very low certainty of evidence). There was a dose-response gradient between the number of MetS components and PE, with a gradual increase in the effect magnitude for 1 (OR = 1.14), 2 (OR = 1.52), 3 or more (OR = 1.79), and 4 or 5 components (OR = 2.02) (low to high certainty of evidence).
MetS was associated with PE, with a dose-response gradient between the number of MetS components and the occurrence of PE, with an increasing effect magnitude according to an increasing number of components.
Periodontal examination should be part of a comprehensive propaedeutic approach of MetS patients, particularly those presenting a great number of components.
评估代谢综合征（MetS）各组分与牙周炎（PE）之间的关联作用。
系统检索了 PUBMED、Scielo 和 Lilacs 数据库，检索时限截至 2022 年 4 月。纳入评估成人和老年人群中 MetS 与 PE 之间关联的横断面、病例对照和队列研究。采用随机效应荟萃分析确定关联效应估计值。结果解释遵循方法学质量评估（Joana Briggs 研究所工具）和证据确定性（GRADE 方法）。
该综述纳入了 52 项研究，共计 140434 名参与者，其中 38 项研究进行了荟萃分析。观察到 PE 与 MetS 之间存在关联（比值比从 1.27 到 1.90；比值比从 1.19 到 1.37）（低和极低确定性证据）。高血糖（比值比=1.18）、高密度脂蛋白（比值比=1.16）、肥胖（比值比=1.08）和高血压（比值比=1.11）与 PE 相关，而甘油三酯除外（低和极低确定性证据）。随着 MetS 组分数量的增加，PE 的发生呈剂量反应梯度，增加 MetS 组分的数量（从 1 个到 4 个或 5 个）与 PE 发生的比值比逐渐增加（1：比值比=1.14；2：比值比=1.52；3 个或更多：比值比=1.79；4 个或 5 个：比值比=2.02）（低到高确定性证据）。
MetS 与 PE 相关，随着 MetS 组分数量的增加，PE 的发生呈剂量反应梯度，随着组分数量的增加，其效应幅度逐渐增大。
牙周检查应作为 MetS 患者全面诊断方法的一部分，尤其是那些存在大量组分的患者。
