Resumen de Association Between Metabolic Syndrome and Periodontal Disease Measures in Postmenopausal Women: The Buffalo OsteoPerio Study
Michael J. LaMonte, AnnaLynn M. Williams, Robert J. Genco, C. A. Andrews, Kathleen M. Hovey, Amy E. Millen, Richard W. Browne, Maurizio Trevisan, Jean Wactawski-Wende
Background: The objective of this study is to characterize the association between metabolic syndrome (MetS) and periodontitis in women, for which there is limited evidence.
Methods: Cross-sectional associations between MetS and periodontitis were examined in 657 postmenopausal women aged 50 to 79 years enrolled in a periodontal disease study ancillary to the Women’s Health Initiative Observational Study. Whole-mouth measures of alveolar crest height (ACH), clinical attachment level (CAL), probing depth (PD), gingival bleeding, and supragingival plaque and measures to define MetS using National Cholesterol Education Program criteria were from a clinical examination. Study outcomes were defined as: 1) mean ACH ≥3 mm, two sites ≥5 mm, or tooth loss to periodontitis; 2) ≥2 sites with CAL ≥6 mm and ≥1 site with PD ≥5 mm; 3) gingival bleeding at ≥50% of sites; and 4) supragingival plaque at ≥50% of sites. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
Results: In unadjusted analyses, MetS (prevalence: 25.6%) was significantly associated with supragingival plaque (OR = 1.74; 95% CI: 1.22 to 2.50) and non-significantly associated with periodontitis defined by ACH (OR = 1.23; 95% CI: 0.81 to 1.85) and gingival bleeding (OR = 1.20; 95% CI: 0.81 to 1.77). Adjustment for age, smoking, and other confounders attenuated observed associations, though supragingival plaque remained significant (OR = 1.47; 95% CI: 1.00 to 2.16; P = 0.049). MetS was not associated with periodontitis defined by CAL and PD.
Conclusions: A consistent association between MetS and measures of periodontitis was not seen in this cohort of postmenopausal women. An association between MetS and supragingival plaque requires further investigation.
Periodontal disease is a common, preventable disease with increasing public health implications among older adults.1,2 Recent findings indicate that 64% of U.S. adults 65 years and older have moderate to severe periodontal disease.3 Periodontal disease is associated with impaired dietary intake4 and quality of life5 and higher risk of diabetes6 and cardiovascular mortality7 in older adults. Established periodontal risk factors include smoking, poorly controlled diabetes, and poor oral hygiene.8 Identifying other modifiable risk factors is a priority to improve population control of periodontal disease and its clinical complications.1,2,8 Metabolic syndrome (MetS) is a condition of coexisting factors including elevated blood pressure, dyslipidemia, hyperglycemia, and obesity that more than doubles the relative risks of diabetes and atherothrombosis.9,10 MetS afflicts 55% of U.S. women 60 years and older11 likely owing to estrogen deficiency–induced abdominal fat accretion and hepatic lipase upregulation common with menopause.12 MetS is a putative factor for modified host immune response and acceleration of periodontitis.13 Studies suggest that MetS could be adversely associated with periodontal disease.14-24 No study has focused on older postmenopausal women, who may be particularly susceptible to both conditions. The aim of the present study is to examine cross-sectional associations between MetS and several measures of periodontal disease in a well-characterized cohort of community-dwelling postmenopausal women.
