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Boitor O, Stoica F, Mihăilă R, Stoica LF, Stef L. Automated Machine Learning to Develop Predictive Models of Metabolic Syndrome in Patients with Periodontal Disease. Diagnostics (Basel) 2023; 13:3631. [PMID: 38132215 PMCID: PMC10743072 DOI: 10.3390/diagnostics13243631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Metabolic syndrome is experiencing a concerning and escalating rise in prevalence today. The link between metabolic syndrome and periodontal disease is a highly relevant area of research. Some studies have suggested a bidirectional relationship between metabolic syndrome and periodontal disease, where one condition may exacerbate the other. Furthermore, the existence of periodontal disease among these individuals significantly impacts overall health management. This research focuses on the relationship between periodontal disease and metabolic syndrome, while also incorporating data on general health status and overall well-being. We aimed to develop advanced machine learning models that efficiently identify key predictors of metabolic syndrome, a significant emphasis being placed on thoroughly explaining the predictions generated by the models. We studied a group of 296 patients, hospitalized in SCJU Sibiu, aged between 45-79 years, of which 57% had metabolic syndrome. The patients underwent dental consultations and subsequently responded to a dedicated questionnaire, along with a standard EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) questionnaire. The following data were recorded: DMFT (Decayed, Missing due to caries, and Filled Teeth), CPI (Community Periodontal Index), periodontal pockets depth, loss of epithelial insertion, bleeding after probing, frequency of tooth brushing, regular dental control, cardiovascular risk, carotid atherosclerosis, and EQ-5D-5L score. We used Automated Machine Learning (AutoML) frameworks to build predictive models in order to determine which of these risk factors exhibits the most robust association with metabolic syndrome. To gain confidence in the results provided by the machine learning models provided by the AutoML pipelines, we used SHapley Additive exPlanations (SHAP) values for the interpretability of these models, from a global and local perspective. The obtained results confirm that the severity of periodontal disease, high cardiovascular risk, and low EQ-5D-5L score have the greatest impact in the occurrence of metabolic syndrome.
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Affiliation(s)
- Ovidiu Boitor
- Dental Medicine Research Center, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Florin Stoica
- Department of Mathematics and Informatics, Research Center in Informatics and Information Technology, Faculty of Sciences, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Romeo Mihăilă
- Department of Internal Medicine, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Laura Florentina Stoica
- Department of Mathematics and Informatics, Research Center in Informatics and Information Technology, Faculty of Sciences, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Laura Stef
- Department of Oral Health, Dental Medicine Research Center, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
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Rosário-Dos-Santos HL, Miranda SS, Gomes-Filho IS, Cruz SSD, Figueiredo ACMG, Souza ES, Hintz AM, Loomer PM, Passos-Soares JDS. Periodontitis severity relationship with metabolic syndrome: A systematic review with meta-analysis. Oral Dis 2023; 29:2512-2520. [PMID: 36346175 DOI: 10.1111/odi.14428] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022]
Abstract
The objective of this study was to investigate the association between periodontitis severity and metabolic syndrome (MetS) through systematic review, registered in PROSPERO: CRD42021232120. Selected articles were independently chosen by three reviewers from six databases, including using article reference lists, up until March 2022. Eligible studies were observational, without language limitation, and in subjects aged at least 18 years. The methodological quality of selected studies was assessed using the Newcastle-Ottawa Scale. Random effects models calculated summary measurements (odds ratio-OR, 95% confidence interval, 95%CI). The I2 test evaluated the statistical heterogeneity of the data. Sensitivity, subgroup, and meta-regression analyses were performed. For the reliability of evidence, the Grading of Recommendations, Assessment, Development, and Evaluations tool was used. A total of 2133 records were identified, and 14 studies were included comprising 24,567 participants. The summary odds ratio showed a positive association between individuals with moderate (ORadjusted = 1.26; 95%CI = 2.10-5.37; I2 = 45.85%), and severe periodontitis (ORadjusted = 1.50; 95%CI:1.28-1.71; I2 = 56.46%), and MetS. Subgroup and meta-regression analyses showed that study effect size was influenced by year of publication, study design, and MetS diagnostic criteria, contributing to inter-study variability. The findings showed that moderate and severe levels of periodontitis are associated with MetS, suggesting a possible dose-response effect.
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Affiliation(s)
| | | | | | - Simone Seixas da Cruz
- Health Sciences Center, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Brazil
| | | | - Elivan Silva Souza
- Department of Health Sciences, University of Brasilia, Distrito Federal, Brazil
| | | | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Saito M, Shimazaki Y, Yoshii S, Takeyama H. Association of self-rated chewing function and oral health status with metabolic syndrome. J Oral Sci 2023; 65:29-33. [PMID: 36529512 DOI: 10.2334/josnusd.22-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The study aimed to examine the association of self-rated chewing function, the number of teeth and periodontal status with metabolic syndrome. METHODS The participants were 11,119 adults aged 40-74 years who underwent specific health checkups, including an oral health examination, in 2018 in Japan. This study used the standard questions of the specific health checkups to obtain information on self-rated chewing function. A multinomial logistic regression analysis was performed with metabolic syndrome status as the dependent variable, and age, sex, lifestyle questions, self-rated chewing function, number of teeth, and periodontal status as the independent variables. RESULTS Number of teeth and periodontal status were significantly associated with metabolic syndrome after adjusting for confounding variables. Self-rated chewing function was significantly associated with metabolic syndrome in the crude analysis, but not after adjustment for confounding variables. Both number of teeth and periodontal status were significantly associated with self-rated chewing function. CONCLUSION There was no significant direct association between self-rated chewing function and metabolic syndrome. Self-rated chewing function may be an indicator of poor oral condition that links to metabolic syndrome.
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Affiliation(s)
- Mizuki Saito
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University
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Milanesi FC, Greggianin BF, Dos Santos GO, Toniazzo MP, Weidlich P, Gerchman F, Oppermann RV. Effect of periodontal treatment on glycated haemoglobin and metabolic syndrome parameters: A randomized clinical trial. J Clin Periodontol 2023; 50:11-21. [PMID: 36053828 DOI: 10.1111/jcpe.13717] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Abstract
AIM To assess the effect of periodontal treatment on HbA1c and diagnostic parameters of patients with metabolic syndrome (MetS). MATERIALS AND METHODS One hundred and fifty-eight patients with MetS and moderate and severe periodontitis were included. They were randomized into a test group (n = 79), which received non-surgical periodontal treatment, and a control group (n = 79), which received no treatment. Medical treatment was delivered to both groups. Clinical periodontal, anthropometric and serological parameters were assessed at baseline, 3 and 6 months. The main outcome was glycated haemoglobin (HbA1c) levels, and the secondary outcomes were changes in the MetS parameters, C-reactive protein (CRP) and HOMA indexes. RESULTS Significant reductions in all periodontal parameters were observed in the test group, compared with the control group, at 3 and 6 months (p < .001). HbA1c levels, MetS parameters, CRP and HOMA indexes showed no significant differences between the test group and the control group at 3 and 6 months. CONCLUSIONS Periodontal treatment led to a substantial reduction in periodontal inflammation, although there was no significant effect on the parameters used for MetS diagnosis in patients with early diagnosed and well-controlled MetS.
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Affiliation(s)
- Fernanda C Milanesi
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna F Greggianin
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela O Dos Santos
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mirian P Toniazzo
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Weidlich
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rui V Oppermann
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Parveen S, Alhazmi YA. Impact of Intermittent Fasting on Metabolic Syndrome and Periodontal Disease-A Suggested Preventive Strategy to Reduce the Public Health Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114536. [PMID: 36361416 PMCID: PMC9657467 DOI: 10.3390/ijerph192114536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 05/27/2023]
Abstract
Metabolic syndrome (MetS) prevalence continues to climb significantly worldwide in today's ad libitum society. MetS has tremendous societal and economic ramifications, making it imperative to develop effective strategies for preventing and controlling it to alleviate this growing burden. Periodontal disease and MetS are associated with several risk factors. Studies in the past have demonstrated that obesity, cardiovascular illness, and type 2 diabetes mellitus have a negative effect on the severity of the periodontal disease. Patients with metabolic syndrome have elevated serum levels of proinflammatory mediators such as tumor necrosis factor-alpha interleukin-6 and C-reactive protein. Similar inflammatory mediators, such as interleukin-6, tumor necrosis factor-alpha, and C-reactive protein, are increased in patients with severe periodontal disease. Remarkably, intermittent fasting is underpinned by scientific evidence, claiming to be the most effective non-pharmacological, potential therapeutic alternative for combating a wide range of metabolic, inflammatory, and lifestyle-related diseases. Nonetheless, an insufficient investigation has been performed to determine whether intermittent fasting has therapeutic benefits on periodontal inflammation and diseases. Here, we show the interrelationship between metabolic syndrome and periodontal disease and contextualize the beneficial impact of intermittent fasting in modulating the chronic metabolic and periodontal inflammatory response. We also anticipate that this review paves the way for further exploration of intermittent fasting as a unique research paradigm representing a cost-effective alternative strategy to conventional disease management in patients with periodontal diseases and metabolic syndrome which may serve as the foundation for an integrative vision relevant to primary, diagnostic, and therapeutic purposes.
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Campos JR, Martins CC, Faria SFS, Carvalho AP, Pereira AG, Costa FO, Cota LOM. Association between components of metabolic syndrome and periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:5557-5574. [PMID: 35716205 DOI: 10.1007/s00784-022-04583-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/09/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the role of metabolic syndrome (MetS) components in the association with periodontitis (PE) (#CRD42020218310). MATERIALS AND METHODS 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). RESULTS This review included 52 studies, totalling 140,434 participants, and 38 studies were meta-analyzed. Association between PE and MetS was observed (ORadj from 1.27 to 1.90; PRajd = 1.19; RRadj 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). CONCLUSIONS 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. CLINICAL RELEVANCE Periodontal examination should be part of a comprehensive propaedeutic approach of MetS patients, particularly those presenting a great number of components.
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Affiliation(s)
- Julya Ribeiro Campos
- 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
| | - Carolina Castro Martins
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandro Felipe Santos Faria
- 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
| | - Ana Paula Carvalho
- 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
| | - Alexandre Godinho Pereira
- 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
| | - Fernando Oliveira Costa
- 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
| | - Luís Otávio Miranda Cota
- 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.
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Baskaradoss JK, Tavares M, Al-Mulla F, Al-Ozairi E, Abu-Farha M, Bin-Hasan S, Alsumait A, Devarajan S, Alqaderi H. Association between Frequency of Toothbrushing and Metabolic Syndrome among Adolescents: A 5-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010508. [PMID: 35010768 PMCID: PMC8744688 DOI: 10.3390/ijerph19010508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023]
Abstract
This study longitudinally examines the relationship between the frequency of toothbrushing and the development of selected components of metabolic syndrome (MetS), along with the potential role of salivary biomarkers in this relationship. In 2014, 6317 12-year-old children underwent health examinations (T1), of which, 348 children participated in the second stage of data collection in 2019 (T2). The association between the change in the metabolic status during the 5-year follow-up examination (between T1 and T2) and frequency of toothbrushing was assessed using multinomial logistic regression analyses. At T2, healthy adolescents had significantly higher odds of toothbrushing twice or more daily compared with adolescents with components of MetS (OR = 1.99, 95% CI 1.15–3.45). Adolescents who were healthy at T1 but developed components of MetS at T2, had significantly higher frequencies of dining-out compared with adolescents with components of MetS at both T1 and T2 (OR = 0.09, 95% CI 0.02 to 0.49). Adolescents who were ‘healthy’ at both T1 and T2 had significantly (p < 0.05) lower levels of C-reactive protein (T2), insulin (T1 and T2), interleukin-6 (T1) and adiponectin (T1) compared with adolescents who had components of MetS. Toothbrushing and frequency of dining-out were associated with the presence of MetS components.
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Affiliation(s)
- Jagan Kumar Baskaradoss
- Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait City 13110, Kuwait
- Correspondence: ; Tel.: +965-2463-6807
| | - Mary Tavares
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA;
| | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
| | - Ebaa Al-Ozairi
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City 13110, Kuwait
| | - Mohamed Abu-Farha
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
| | - Saadoun Bin-Hasan
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
- Farwaniya Hospital, Ministry of Health, Farwaniya 92400, Kuwait
| | - Aishah Alsumait
- Kuwait School Oral Health Program, Ministry of Health, P.O. Box No. 5338, Salmiya 22064, Kuwait;
| | - Sriraman Devarajan
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
| | - Hend Alqaderi
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait; (F.A.-M.); (E.A.-O.); (M.A.-F.); (S.B.-H.); (S.D.); (H.A.)
- Kuwait School Oral Health Program, Ministry of Health, P.O. Box No. 5338, Salmiya 22064, Kuwait;
- Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Sayeed G, Varghese SS. Association Between Periodontitis and Metabolic Syndrome in Females: A Systematic Review and Meta-analysis. J Int Soc Prev Community Dent 2021; 11:609-625. [PMID: 35036370 PMCID: PMC8713494 DOI: 10.4103/jispcd.jispcd_168_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/12/2021] [Accepted: 07/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Metabolic syndrome (MetS) and periodontal diseases (PDs) have shown a bidirectional and vice versa relationship. Hence, this study aimed to identify the extent and magnitude between MetS and PDs in females. Materials and Methods: A published literature was explored by considering case–control, cross-sectional, and cohort studies that involved patients with measurements of MetS and PD. Ovid MEDLINE, EMBASE, LILACS, and Cochrane Library databases were used for the search. This study examined the relationship between the MetS and PD among females. Results: Of the initial 4150 titles screened, a total of 37 reported papers were eligible for quantitative review. A gender-wise analysis of the findings revealed a crude odds ratio (OR) of 1.385 [95% confidence interval (CI): 1.043–1.839, I2 = 94.61%, P < 0.001] for the females relative to the average OR of 1.54 (95% CI: 1.39–1.71, I2 = 90.95%, P < 0.001). Further subgroup analysis for directionality in females revealed the crude ORs of 1.28 (95% CI: 0.91–1.79, I2 = 96.44%, P < 0.001) for the relationship between PD and MetS, whereas an OR of 2.12 (95% CI: 0.78–5.73, I2 = 88.31%, P < 0.001) was found between MetS and PDs. Conclusion: This study lacks convincing proof of a link between MetS and PDs in females when compared with an overall association between MetS and PDs. Directionality indicated higher odds of linking between MetS and PD than PD and MetS among females. Further longitudinal and treatment trials are needed to confirm the association among females.
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Affiliation(s)
- Ghousia Sayeed
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Sheeja S Varghese
- Department of Periodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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10
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Ngoude JXE, Moor VJA, Nadia-Flore TT, Agoons BB, Marcelle GGC, MacBrain EE, Tcheutchoua DN, Nkeck JR. Relationship between periodontal diseases and newly-diagnosed metabolic syndrome components in a sub-Saharan population: a cross sectional study. BMC Oral Health 2021; 21:326. [PMID: 34187434 PMCID: PMC8244141 DOI: 10.1186/s12903-021-01661-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background Oral health is a frequently ignored aspect of global health in sub-Saharan patients. Periodontitis, a very frequent oral disease has been proven to be associated to development of the metabolic syndrome. This study aims to evaluate the relationship between periodontal disease and metabolic syndrome components in a sub-Saharan population.
Methods We performed a cross sectional study in 3 Yaounde hospitals. Consenting adults aged 21 years and above were recruited. Participants who presented with a tooth loss of at least 50% or any condition which could alter values of biological and periodontal parameters (tobacco smoking, pregnancy, chronic kidney disease, cancer) were excluded. Metabolic syndrome elements (glycaemia, arterial pressure, HDL cholesterol, abdominal circumference, triglycerides) and periodontal variables were recorded (plaque and gingival index of Silness and Loe, periodontal pocket depth and clinical attachment loss). These variables were compared using Fisher’s exact Test and odds ratio calculated with 95% confidence intervals. Results The prevalence of periodontitis and metabolic syndrome were 43.4% and 10.8% respectively. Age (37.75 ± 13.25, P < 0.001) and poor accessory brushing methods were associated risk factors for development of periodontal disease. Sub-Saharan sindividuals with periodontitis had increased odds of having obesity (OR 11.1 [95% CI 3.97–31.03], P < 0.001) and low HDL (OR 4.58 [95% CI 1.79–11.70], P = 0.001) Conclusion Our findings suggest an association between periodontal disease and metabolic syndrome in Sub-Saharan subjects. Increasing age and poor accessory brushing methods are associated risk indicators.
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Affiliation(s)
| | - Vicky Jocelyne Ama Moor
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Biochemistry Laboratory, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon
| | | | - Batakeh B Agoons
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | | | - Elage Epie MacBrain
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Jan René Nkeck
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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11
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Gomes-Filho IS, Santos PNP, Cruz SS, Figueiredo ACMG, Trindade SC, Ladeia AM, Cerqueira EMM, Passos-Soares JS, Coelho JMF, Hintz AM, Barreto ML, Fischer RG, Loomer PM, Scannapieco FA. Periodontitis and its higher levels of severity are associated with the triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio. J Periodontol 2021; 92:1509-1521. [PMID: 33689171 DOI: 10.1002/jper.21-0004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Periodontitis and the Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio have both been associated with cardiovascular disease, metabolic syndrome, and obesity. Additionally, the ratio is a possible substitute for predicting insulin resistance. This study investigated the association between periodontitis, its severity levels (exposures), and the TG/HDL-C ratio (outcome). METHODS A cross-sectional study of public health service users in Brazil considered socioeconomic-demographic characteristics, lifestyle behavior, and general and oral health conditions. Anthropometric measurements and blood pressure were also measured. Systemic biomarker data were obtained, as well as assessment of periodontal diagnosis and its severity. The TG/HDL-C ratio was calculated using the serum triglyceride level over HDL cholesterol and the cut-off point, TG/HDL-C ≥2.3 serving as the cutoff indicting dyslipidemia. Logistic and linear regressions were used to statistically analyze the data. RESULTS A total of 1011 participants were included, with 84.17% having periodontitis and 49.85% having a TG/HDL-C ratio ≥2.3. For individuals with periodontitis, the odds of TG/HDL-C ratio ≥2.3 were 1.47 times greater than in those without periodontitis (ORAdjusted = 1.47, 95% CI: 1.02-2.14). Similar results were found for those with moderate and severe periodontitis, with a slight increase in the measurement magnitude with disease severity. CONCLUSION A positive relationship between periodontitis and the TG/HDL-C ratio ≥2.3 was found, suggesting a possible association with periodontal disease severity.
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Affiliation(s)
- Isaac S Gomes-Filho
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | - Pedro N P Santos
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | - Simone S Cruz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil.,Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | - Ana C M G Figueiredo
- Epidemiology Surveillance, Federal District Health State Department, Distrito Federal, Brasília, Brazil
| | - Soraya C Trindade
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | - Ana M Ladeia
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Bahia, Brazil
| | - Eneida M M Cerqueira
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | | | - Julita M F Coelho
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | - Alexandre M Hintz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | - Maurício L Barreto
- Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ricardo G Fischer
- Department of Periodontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Peter M Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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12
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Gomes-Filho IS, Balinha IDSCE, da Cruz SS, Trindade SC, Cerqueira EDMM, Passos-Soares JDS, Coelho JMF, Ladeia AMT, Vianna MIP, Hintz AM, de Santana TC, Dos Santos PP, Figueiredo ACMG, da Silva ICO, Scannapieco FA, Barreto ML, Loomer PM. Moderate and severe periodontitis are positively associated with metabolic syndrome. Clin Oral Investig 2020; 25:3719-3727. [PMID: 33226499 DOI: 10.1007/s00784-020-03699-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study investigated the association between periodontitis severity (exposure) and metabolic syndrome (MetS - outcome), using two criteria for diagnosis of the outcome, since this relationship remains unexplored. MATERIALS AND METHODS A case-control study was conducted with 870 individuals: 408 with first MetS diagnosis (cases) and 462 without MetS (controls). Participants' general information was obtained using a questionnaire and laboratory data was collected from medical records. Periodontitis severity criteria followed the Center for Disease Control and Prevention: none, mild, moderate, and severe. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by logistic regression analysis. RESULTS Findings showed a positive association between moderate and severe periodontitis and MetS: ORadjusted = 1.64 (95% CI: 1.01 to 2.68) and ORadjusted = 1.94 (95% CI: 1.19 to 3.16), respectively, after adjustment for age, sex, schooling level, smoking habit, and cardiovascular disease. The adjusted measurements showed that among individuals with moderate or severe periodontitis, the probability of having MetS was around two times greater than among those without periodontitis, and that the chance was greater among participants with severe periodontitis than those with moderate periodontitis. CONCLUSION An association between the severity of periodontal status and MetS was found, suggesting a possible relationship between the two diseases. CLINICAL RELEVANCE MetS influences the etiology of cardiovascular diseases, one of the leading causes of mortality worldwide. The findings suggest that the greater the severity of periodontitis, the greater is the association magnitude with MetS. The health professional needs to recognize that the importance of periodontal disease may play in MetS.
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Affiliation(s)
- Isaac Suzart Gomes-Filho
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil.
| | - Izadora da S C E Balinha
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Simone S da Cruz
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil.,Health Sciences Center, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Soraya C Trindade
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Eneida de M M Cerqueira
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Johelle de S Passos-Soares
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil.,Department of Preventive Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Julita Maria F Coelho
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Ana Marice T Ladeia
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Bahia, Brazil
| | - Maria Isabel P Vianna
- Department of Preventive Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Alexandre M Hintz
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Teresinha C de Santana
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | - Pedro P Dos Santos
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | | | - Ivana C O da Silva
- Department of Health, Feira de Santana State University, Avenida Getúlio Vargas, 379, Centro, Feira de Santana, Bahia, 44025-010, Brazil
| | | | - Maurício L Barreto
- Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Peter M Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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13
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Isola G, Alibrandi A, Rapisarda E, Matarese G, Williams RC, Leonardi R. Association of vitamin D in patients with periodontitis: A cross-sectional study. J Periodontal Res 2020; 55:602-612. [PMID: 32173876 DOI: 10.1111/jre.12746] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/13/2020] [Accepted: 02/21/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Vitamin D has been considered to possess anti-inflammatory and antimicrobial activity, which may be a link for the known interaction of periodontitis (CP) and coronary heart disease (CHD). This study investigated the association between serum vitamin D levels and periodontitis in patients with CP and with CHD. Furthermore, the objective was to determine whether periodontitis and CHD had an impact on serum vitamin D levels. MATERIAL AND METHODS Using a cross-sectional design, a total of 46 patients with CP, 45 patients with CHD, 45 patients with both CP and CHD, and 43 healthy patients were enrolled in the present study. RESULTS Patients in the CP (17.4 ± 5.2 ng/mL) and in the CP + CHD (16.5 ± 5.6 ng/mL) group presented a significantly lower mean serum level of 25(OH)vitamin D compared to patients in the CHD (24.6 ± 3.7 ng/mL) and healthy control groups (29.9 ± 5.4 ng/mL) (P < .001). 25(OH)vitamin D levels were positively correlated with the number of teeth and negatively with C-reactive protein (CRP) and all periodontal parameters (P < .001). In all patients, there was a proportional increase of 25(OH)vitamin D levels with a progressive increase in number of teeth (P-trend <.001) while there were a proportional decrease in 25(OH)vitamin D levels with a progressive increase in clinical attachment level (CAL, P-trend = .001), probing depth (PD, P-trend = .006), and bleeding sites (BOP, P-trend <.001) levels. CONCLUSION Patients with CP and CP + CHD presented significantly lower serum levels of vitamin D compared to CHD and healthy controls. Moreover, the presence of CP negatively influenced serum vitamin D levels.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, Messina, Italy
| | - Ernesto Rapisarda
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Giovanni Matarese
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy
| | - Ray C Williams
- Department of Periodontology, UNC-Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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14
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Muñoz Aguilera E, Suvan J, Buti J, Czesnikiewicz-Guzik M, Barbosa Ribeiro A, Orlandi M, Guzik TJ, Hingorani AD, Nart J, D'Aiuto F. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovasc Res 2020; 116:28-39. [PMID: 31549149 DOI: 10.1093/cvr/cvz201] [Citation(s) in RCA: 184] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
Recent evidence suggests a link between periodontitis (PD) and hypertension, but the nature of this association remains unclear. The overall aim of this review was to critically appraise the evidence linking these two common disorders. Systematic search was conducted for studies published up to December 2018. Prevalence of hypertension in patients with PD (moderate/severe groups) vs. those without PD (non-PD) was the primary outcome. Additional outcomes included adjusted mean difference in systolic (SBP) and diastolic (DBP) blood pressure (BP) levels in PD vs. non-PD, assessment of biomarkers in PD and hypertension, and BP changes after periodontal therapy. From 81 studies selected, 40 were included in quantitative meta-analyses. Diagnoses of moderate-severe PD [odds ratio (OR) = 1.22; 95% confidence interval (CI): 1.10-1.35] and severe PD (OR = 1.49; 95% CI: 1.09-2.05) were associated with hypertension. Prospective studies confirmed PD diagnosis increased likelihood of hypertension occurrence (OR = 1.68; 95% CI: 0.85-3.35). Patients with PD exhibited higher mean SBP [weighted mean difference (WMD) of 4.49 mmHg; 95% CI: 2.88-6.11] and DBP (2.03 mmHg; 95% CI: 1.25-2.81) when compared with non-PD. Lastly, only 5 out of 12 interventional studies confirmed a reduction in BP following periodontal therapy, ranging from 3 to 12.5 mmHg of SBP and from 0 to 10 mmHg of DBP. PD is associated with increased odds of hypertension (SORT C) and higher SBP/DBP levels. The evidence suggesting that PD therapy could reduce BP is inconclusive. Although additional research is warranted on this association, these results suggest that oral health assessment and management of PD could not only improve oral/overall health and quality of life but also be of relevance in the management of patients with hypertension.
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Affiliation(s)
- Eva Muñoz Aguilera
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK.,Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Jean Suvan
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Jacopo Buti
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aline Barbosa Ribeiro
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Marco Orlandi
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Tomasz J Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aroon D Hingorani
- Genetic Epidemiology, Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK
| | - Jose Nart
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Francesco D'Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
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15
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Pussinen PJ, Paju S, Viikari J, Salminen A, Taittonen L, Laitinen T, Burgner D, Kähönen M, Lehtimäki T, Hutri-Kähönen N, Raitakari O, Juonala M. Childhood Oral Infections Associate with Adulthood Metabolic Syndrome: A Longitudinal Cohort Study. J Dent Res 2020; 99:1165-1173. [PMID: 32479136 PMCID: PMC7443963 DOI: 10.1177/0022034520929271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Chronic oral infection/inflammation is cross-sectionally associated with metabolic syndrome (MetS) in adults, but there are few longitudinal studies and studies on childhood oral infections and adult MetS risk. We investigated whether childhood clinical parameters indicative of oral infection/inflammation were associated with adulthood MetS and its components. A total of 755 children aged 6, 9, and 12 y underwent a clinical oral examination in 1980 as part of the Cardiovascular Risk in Young Finns Study. Oral health measures included bleeding on probing (BOP), periodontal probing pocket depth, caries, fillings, and visible plaque. Metabolic parameters were determined at baseline and during follow-up. MetS was diagnosed (n = 588, 77.9%) in the adulthood at 21 y (in 2001), 27 y (in 2007), and 31 y (in 2011) after the oral assessment, when the participants were 27 to 43 y old. Regression analyses were adjusted for childhood age, sex, body mass index, and family income, as well as adulthood smoking and education level. In adulthood, MetS was diagnosed in 11.9% (2001), 18.7% (2007), and 20.7% (2011) of participants at the 3 follow-ups. Childhood caries and fillings were associated with increased risk of adult MetS (risk ratio [95% CI], 1.25 [0.90 to 2.45] and 1.27 [1.02 to 1.99]) and with increased systolic blood pressure (1.78 [1.01 to 4.26] and 2.48 [1.11 to 4.12]) and waist circumference (2.25 [1.02 to 4.99] and 1.56 [1.01 to 3.25]), whereas BOP and visible plaque were associated with plasma glucose (1.97 [1.08 to 3.60] and 1.88 [1.00 to 3.53]). Severity of BOP (P = 0.015) and caries (P = 0.005) and teeth with plaque (P = 0.027) were associated with number of MetS components. No such trends were seen with probing pocket depth. Childhood oral infection/inflammation was associated with adverse metabolic parameters and MetS in adulthood.
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Affiliation(s)
- P J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - S Paju
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Viikari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - A Salminen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | | | - T Laitinen
- University of Eastern Finland, Kuopio, Finland
| | - D Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - M Kähönen
- University of Tampere, Tampere, Finland
| | - T Lehtimäki
- Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - O Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - M Juonala
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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16
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Gobin R, Tian D, Liu Q, Wang J. Periodontal Diseases and the Risk of Metabolic Syndrome: An Updated Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:336. [PMID: 32582028 PMCID: PMC7296056 DOI: 10.3389/fendo.2020.00336] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Periodontitis and metabolic syndrome (MetS) are two major global health problems that are widely prevalent in the world, although the former is a common infection in developing countries and the latter is a non-infectious but prevalent disease in developed countries. This study aims to provide an updated review on the existence and magnitude of the relationship between periodontal disease and the risk of MetS. Methods: We searched the PubMed, Web of Science, ScienceDirect, Chinese National Knowledge Infrastructure, and Wanfang databases for original studies assessing the association between periodontitis and MetS published before August 2019. We calculated the pooled crude and adjusted odds ratios (ORs) together with the 95% confidence intervals (95% CIs) to estimate the strength of this association. Subgroup analysis was performed by considering the diagnostic method or the country where the studies were performed. Results: We identified 43 potentially eligible articles for this systematic review, including 32 cross-sectional studies, eight case-control studies, and three cohort studies. Among them, 39 articles presented enough information to be included in the meta-analysis. The pooled crude and adjusted ORs were 1.99 (95% CI: 1.75-2.25) and 1.46 (95% CI: 1.31-1.61), respectively. Subgroup analysis showed a consistent relation stratified by either the diagnostic method or the country where the studies were performed. The pooled OR was 1.68 (95% CI: 1.41-2.00) for Japan, 1.75 (95% CI: 1.31-2.34) for the USA, 1.81 (95% CI: 1.35-2.42) for Korea, and 2.29 (95% CI: 1.53-3.41) for China. Conclusion: Our results provide compelling evidence for the association between periodontitis and MetS. Patients with periodontal disease are a critical screening population for MetS. We also recommend that people exhibiting components of MetS should receive a periodontal check-up and pay attention to their oral health.
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Affiliation(s)
- Romila Gobin
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dan Tian
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qiao Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Jianming Wang
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17
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Minty M, Canceil T, Serino M, Burcelin R, Tercé F, Blasco-Baque V. Oral microbiota-induced periodontitis: a new risk factor of metabolic diseases. Rev Endocr Metab Disord 2019; 20:449-459. [PMID: 31741266 DOI: 10.1007/s11154-019-09526-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It has recently become evident that the periodontium (gingiva, desmodontal ligament, cementum and alveolar bone) and the associated microbiota play a pivotal role in regulating human health and diseases. The oral cavity is the second largest microbiota in the body with around 500 different bacterial species identified today. When disruption of oral cavity and dysbiosis occur, the proportion of strict anaerobic Gram-negative bacteria is then increased. Patients with periodontitis present 27 to 53% more risk to develop diabetes than the control population suggesting that periodontitis is an aggravating factor in the incidence of diabetes. Moreover, dysbiosis of oral microbiota is involved in both periodontal and metabolic disorders (cardiovascular diseases, dyslipidaemia …). The oral diabetic dysbiosis is characterized by a specific bacteria Porphyromonas, which is highly expressed in periodontal diseases and could exacerbate insulin resistance. In this review, we will address the nature of the oral microbiota and how it affects systemic pathologies with a bidirectional interaction. We also propose that using prebiotics like Akkermansia muciniphila may influence oral microbiota as novel therapeutic strategies. The discovery of the implication of oral microbiota for the control of metabolic diseases could be a new way for personalized medicine.
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Affiliation(s)
- Matthieu Minty
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Thibault Canceil
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Matteo Serino
- INSERM, INRA, ENVT, UPS, IRSD, Université de Toulouse, 31024, Toulouse, France
| | - Remy Burcelin
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - François Tercé
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Vincent Blasco-Baque
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France.
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France.
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France.
- INSERM UMR1048-I2MC Team 2 « Intestinal Risk Factors, Diabetes and Dyslipidemia » Building L4, 1st floor, Hospital of Rangueil 1, Avenue Jean Poulhès, 84225 31432, Toulouse Cedex 4 Lab, BP, France.
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18
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Campos JR, Costa FO, Cota LOM. Association between periodontitis and metabolic syndrome: A case‐control study. J Periodontol 2019; 91:784-791. [DOI: 10.1002/jper.19-0298] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/05/2019] [Accepted: 08/11/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Julya Ribeiro Campos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of DentistryFederal University of Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of DentistryFederal University of Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of DentistryFederal University of Minas Gerais Belo Horizonte Minas Gerais Brazil
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19
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Merces MCD, Gomes AMT, Coelho JMF, Servo MLS, Marques SC, D’Oliveira Júnior A. Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.
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das Merces MC, Santana AIC, Lua I, da Silva DAR, E Silva DDS, Gomes AMT, Miranda MCDM, Barbosa CDS, Magalhães LBNC, Coelho JMF, Servo MLS, Portella DDA, de Souza MC, Lago SB, Araújo EMQ, Marques SC, Figueiredo VP, D'Oliveira Júnior A. Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2686. [PMID: 31357596 PMCID: PMC6696523 DOI: 10.3390/ijerph16152686] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 01/04/2023]
Abstract
This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.
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Affiliation(s)
- Magno Conceição das Merces
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Brazil.
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil.
| | - Amália Ivine Costa Santana
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | - Iracema Lua
- Department of Health, State University of Feira de Santana (UEFS), Feira de Santana 44036-900, Brazil
| | | | - Douglas de Souza E Silva
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | | | | | - Caroline da Silva Barbosa
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | | | | | - Maria Lucia Silva Servo
- Department of Health, State University of Feira de Santana (UEFS), Feira de Santana 44036-900, Brazil
| | | | - Marcio Costa de Souza
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Brazil
| | - Sueli Bonfim Lago
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Brazil
| | | | - Sergio Correa Marques
- School of Nursing, State University of Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil
| | | | - Argemiro D'Oliveira Júnior
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
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21
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Montero E, Herrera D, Sanz M, Dhir S, Van Dyke T, Sima C. Development and validation of a predictive model for periodontitis using NHANES 2011-2012 data. J Clin Periodontol 2019; 46:420-429. [PMID: 30891834 DOI: 10.1111/jcpe.13098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 12/03/2018] [Accepted: 02/24/2019] [Indexed: 12/29/2022]
Abstract
AIM To develop and validate a predictive model for moderate-to-severe periodontitis in the adult USA population, with data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) cycle. MATERIAL AND METHODS A subset of 3017 subjects aged >30 years, with >14 teeth present and having received a periodontal examination in addition to data collected on cardio-metabolic risk measures (smoking habit, body mass index [BMI], blood pressure, total cholesterol and glycated haemoglobin [HbA1c]) were used for model development by multivariable logistic regression. RESULTS The prevalence of moderate and severe periodontitis using CDC/AAP classification was 37.1% and 13.2%, respectively. A multivariable logistic regression model revealed that HbA1c ≥5.7% was significantly associated with moderate-to-severe periodontitis (odds ratio, OR = 1.29; p < 0.01). A predictive model including age, gender, ethnicity, HbA1c and smoking habit as variables had 70.0% sensitivity and 67.6% specificity in detecting moderate-to-severe periodontitis in US adults. CONCLUSIONS Periodontitis is a common disease in North American adults, and its prevalence is significantly higher in individuals with pre-diabetes or diabetes. The present study demonstrates that a model including age, gender, ethnicity, HbA1c and smoking habit could be used as a reliable screening tool for periodontitis in primary medical care settings to facilitate referral of patients at risk for periodontal examination and diagnosis.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Sangeeta Dhir
- Department of Dentistry. Consultant Periodontist, Max Super Specialty Hospital, Saket, New Delhi, India
| | - Thomas Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Corneliu Sima
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
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22
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Li G, Robles S, Lu Z, Li Y, Krayer JW, Leite RS, Huang Y. Upregulation of free fatty acid receptors in periodontal tissues of patients with metabolic syndrome and periodontitis. J Periodontal Res 2018; 54:356-363. [PMID: 30597558 DOI: 10.1111/jre.12636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 11/02/2018] [Accepted: 12/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Metabolic syndrome (MetS) exacerbates periodontitis. Since saturated fatty acid (SFA) is increased in MetS and enhances lipopolysaccharide (LPS)-induced proinflammatory cytokine expression in macrophages, it has been considered to play a role in MetS-exacerbated periodontitis. However, it remains unknown how fatty acid receptors, which mediate the interaction of cells with SFA and uptake of SFA, are expressed and regulated in the periodontal tissue. In this study, we tested our hypothesis that the periodontal expression of fatty acid receptors GPR40 and CD36 is increased in patients with both MetS and periodontitis. We also determined the effect of SFA and LPS on GPR40 and CD36 expression in vitro. MATERIAL AND METHODS Periodontal tissue specimens were collected from 11 participants without MetS and periodontitis, 12 participants with MetS, 11 participants with periodontitis, and 14 participants with both MetS and periodontitis after surgeries. The tissues were processed, and GPR40 and CD36 were detected by immunohistochemistry. Furthermore, cultured macrophages and gingival fibroblasts were treated with LPS, palmitate, a major SFA, or LPS plus palmitate and the expression of GPR40 and CD36 was then quantified. RESULTS Analysis of clinical data showed that age, smoker, gender, and race/ethnicity were not significantly different among 4 groups. Immunohistochemistry showed that GPR40 and CD36 were expressed by epithelial cells, fibroblasts, and immune cells. Quantitative data showed that GPR40 expression is increased in patients with periodontitis, MetS, or both periodontitis and MetS while CD36 expression is increased only in patients with both periodontitis and MetS. The in vitro studies showed that the expression of GPR40 and CD36 in macrophages and fibroblasts was upregulated by the combination of LPS and palmitate. CONCLUSION Periodontal expression of GPR40 and CD36 was upregulated in patients with both MetS and periodontitis, and GPR40 and CD36 in macrophages and fibroblasts were upregulated in vitro by the combination of LPS and palmitate, suggesting that GPR40 and CD36 may be involved in MetS-exacerbated periodontitis.
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Affiliation(s)
- Guang Li
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Samantha Robles
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Yanchun Li
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Joe W Krayer
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Renata S Leite
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina.,Center for Oral Health Research, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Yan Huang
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
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23
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Nascimento GG, Leite FRM, Peres KG, Demarco FF, Corrêa MB, Peres MA. Metabolic syndrome and periodontitis: A structural equation modeling approach. J Periodontol 2018; 90:655-662. [PMID: 30447085 DOI: 10.1002/jper.18-0483] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/10/2018] [Accepted: 11/04/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study aimed to investigate the association between metabolic syndrome (MetS) and periodontitis among young adults, and also to compare results using observed and latent variables for MetS and periodontitis. METHODS Data from the 1982 Pelotas Birth Cohort, Brazil, were used. Metabolic syndrome at the age of 23 years was measured using clinical and biochemical analysis and set as the main exposure. Periodontitis at the age of 31 years was clinically measured and set as the outcome. Confounding variables included sex and maternal education, assessed at birth, family income at 23 years, and smoking status at the age of 23 and 30 years. Factor analyses (exploratory and confirmatory) were performed to define latent variables for MetS and periodontitis. In addition, both conditions were also defined as categorical observed variables. The association between MetS and periodontitis was tested in structural equation models. RESULTS Two latent periodontal variables were identified: "initial" and "advanced" periodontitis, while one latent variable was identified for MetS. Metabolic syndrome is positively associated with "advanced" (coefficient 0.11; P value < 0.01), but not with "initial" (coefficient -0.01; P value = 0.79) periodontitis. When MetS and periodontitis were set as observed variables in the structural equation models, no association was found irrespective of the criteria used for periodontitis classification. CONCLUSIONS There was a positive association between metabolic syndrome and "advanced" periodontitis, when the multiple dimensions of both diseases were accounted in latent variables. Nevertheless, when MetS and periodontitis were treated as observed variables, no association was detected irrespective of the criteria used for periodontitis classification.
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Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fábio R M Leite
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Karen G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas
| | - Marcos B Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marco A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University
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Jin J, Lu Z, Li Y, Ru JH, Lopes-Virella MF, Huang Y. LPS and palmitate synergistically stimulate sphingosine kinase 1 and increase sphingosine 1 phosphate in RAW264.7 macrophages. J Leukoc Biol 2018; 104:843-853. [PMID: 29882996 PMCID: PMC6162112 DOI: 10.1002/jlb.3a0517-188rrr] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 05/15/2018] [Accepted: 05/18/2018] [Indexed: 01/28/2023] Open
Abstract
It has been well established that patients with diabetes or metabolic syndrome (MetS) have increased prevalence and severity of periodontitis, an oral infection initiated by bacteria and characterized by tissue inflammation and destruction. To understand the underlying mechanisms, we have shown that saturated fatty acid (SFA), which is increased in patients with type 2 diabetes or MetS, and LPS, an important pathogenic factor for periodontitis, synergistically stimulate expression of proinflammatory cytokines in macrophages by increasing ceramide production. However, the mechanisms by which increased ceramide enhances proinflammatory cytokine expression have not been well understood. Since sphingosine 1 phosphate (S1P) is a metabolite of ceramide and a bioactive lipid, we tested our hypothesis that stimulation of ceramide production by LPS and SFA facilitates S1P production, which contributes to proinflammatory cytokine expression. Results showed that LPS and palmitate, a major SFA, synergistically increased not only ceramide, but also S1P, and stimulated sphingosine kinase (SK) expression and membrane translocation in RAW264.7 macrophages. Results also showed that SK inhibition attenuated the stimulatory effect of LPS and palmitate on IL-6 secretion. Moreover, results showed that S1P enhanced the stimulatory effect of LPS and palmitate on IL-6 secretion. Finally, results showed that targeting S1P receptors using either S1P receptor antagonists or small interfering RNA attenuated IL-6 upregulation by LPS and palmitate. Taken together, this study demonstrated that LPS and palmitate synergistically stimulated S1P production and S1P in turn contributed to the upregulation of proinflammatory cytokine expression in macrophages by LPS and palmitate.
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Affiliation(s)
- Junfei Jin
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zhongyang Lu
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
| | - Yanchun Li
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ji Hyun Ru
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Maria F Lopes-Virella
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
| | - Yan Huang
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
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25
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Abstract
AIM The aim is to study the effect of glycemic level in Type 2 diabetes and cardiovascular risk factors on periodontal health. MATERIALS AND METHOD Type 2 diabetic and nondiabetic patients in the age group of 35-80 years (n = 1700) were recruited for the study. Periodontal examination included as follows: Probing depth, clinical attachment level (CAL), gingival recession, and bleeding on probing. Periodontitis was diagnosed based on the CAL levels and diabetes was diagnosed based on glycated hemoglobin (HbA1c) levels. Body mass index, total cholesterol, triglyceride, and low-density lipoprotein (LDL) were assessed for cardiovascular risk. Patients were characterized into two groups as follows: diabetic (n = 1235) and nondiabetic (n = 465). Sociodemographic variables included were: age, sex, obesity, smoking, duration of diabetes, and periodontitis were assessed. SPSS version 20.0.1.0 was used for all the statistical assessments. CONCLUSION HbA1c and lipid levels were statistically significant with the severity of periodontitis (odds ratio [OR] [95% confidence interval [CI]: HbA1c 1.34 [1.019-1.21]; Total cholesterol 1.01 [1.03-1.42]; triglycerides 1.01 [1.01-1.14]; LDL 1.028 [1.08-1.71]). Smoking and obesity were also found to be significantly associated with the presence of periodontitis [OR (95% CI): smoking 1.35 (1.10-1.67); obesity 1.23 (1.73-2.05)]. The study concluded that uncontrolled HbA1c levels and elevated cardiovascular risk factors significantly increase the severity of periodontitis in Type 2 diabetes mellitus.
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Affiliation(s)
- Sangeeta Dhir
- Department of Dentistry, Max Superspeciality Hospital, New Delhi, India
| | - Subhash Wangnoo
- Apollo Center of Obesity, Diabetes and Endocrinology, Indraprastha Apollo Hospital, New Delhi, India
| | - Viveka Kumar
- Department of Cardiovascular Sciences, Max Superspeciality Hospital, New Delhi, India
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Daudt LD, Musskopf ML, Mendez M, Remonti LLR, Leitão CB, Gross JL, Weidlich P, Oppermann RV. Association between metabolic syndrome and periodontitis: a systematic review and meta-analysis. Braz Oral Res 2018; 32:e35. [PMID: 29846383 DOI: 10.1590/1807-3107bor-2018.vol32.0035] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/14/2018] [Indexed: 01/11/2023] Open
Abstract
The aim of the present study was to evaluate the association between metabolic syndrome (MS) and periodontitis (PD), through a systematic review and meta-analysis. Original observational studies assessing the association between MS and PD in adults, published before May 11th (2017), were identified through electronic searches of MEDLINE, EMBASE and Cochrane Library databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. For studies to be included, they had to mention the criteria used to diagnose MS and to have used at least one clinical measure to diagnose PD. There was no language restriction. Three reviewers independently identified eligible studies for possible inclusion in the systematic review and meta-analysis. The quality of the studies was evaluated by the Newcastle-Ottawa scale for observational studies. A random model meta-analysis was conducted. The strategies used to investigate heterogeneity were sequential analysis, subgroup analysis, univariate meta-regression and sensitivity analysis. Thirty-three studies met the inclusion criteria for the systematic review, and 26 had enough information to be included in the meta-analysis, totaling 52,504 patients. MS and PD were associated with an odds ratio of 1.38 (95%CI 1.26-1.51; I2 = 92.7%; p < 0.001). Subgroup analysis showed that complete periodontal examination (I2 = 70.6%; p < 0.001) partially explained the variability between studies. The present findings suggest an association between MS and PD. Individuals with MS are 38% more likely to present PD than individuals without this condition. Prospective studies should be conducted to establish cause and effect relations between MS and PD.
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Affiliation(s)
- Luciana Dondonis Daudt
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Periodontology, Porto Alegre, RS, Brazil
| | | | - Marina Mendez
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Luciana Loss Reck Remonti
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Division of Endocrinology, Porto Alegre, Brazil
| | - Cristiane Bauermann Leitão
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Division of Endocrinology, Porto Alegre, Brazil
| | - Jorge Luiz Gross
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Division of Endocrinology, Porto Alegre, Brazil
| | - Patricia Weidlich
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Periodontology, Porto Alegre, RS, Brazil
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Carrouel F, Viennot S, Santamaria J, Veber P, Bourgeois D. Quantitative Molecular Detection of 19 Major Pathogens in the Interdental Biofilm of Periodontally Healthy Young Adults. Front Microbiol 2016; 7:840. [PMID: 27313576 PMCID: PMC4889612 DOI: 10.3389/fmicb.2016.00840] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 05/19/2016] [Indexed: 12/12/2022] Open
Abstract
In oral health, the interdental spaces are a real ecological niche for which the body has few or no alternative defenses and where the traditional daily methods for control by disrupting biofilm are not adequate. The interdental spaces are the source of many hypotheses regarding their potential associations with and/or causes of cardiovascular disease, diabetes, chronic kidney disease, degenerative disease, and depression. This PCR study is the first to describe the interdental microbiota in healthy adults aged 18–35 years-old with reference to the Socransky complexes. The complexes tended to reflect microbial succession events in developing dental biofilms. Early colonizers included members of the yellow, green, and purple complexes. The orange complex bacteria generally appear after the early colonizers and include many putative periodontal pathogens, such as Fusobacterium nucleatum. The red complex (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) was considered the climax community and is on the list of putative periodontal pathogens. The 19 major periodontal pathogens tested were expressed at various levels. F. nucleatum was the most abundant species, and the least abundant were Actinomyces viscosus, P. gingivalis, and Aggregatibacter actinomycetemcomitans. The genome counts for Eikenella corrodens, Campylobacter concisus, Campylobacter rectus, T. denticola, and Tannerella forsythensis increased significantly with subject age. The study highlights the observation that bacteria from the yellow complex (Streptococcus spp., S. mitis), the green complex (E. corrodens, Campylobacter gracilis, Capnocytophaga ochracea, Capnocytophaga sputigena, A. actinomycetemcomitans), the purple complex (Veillonella parvula, Actinomyces odontolyticus) and the blue complex (A. viscosus) are correlated. Concerning the orange complex, F. nucleatum is the most abundant species in interdental biofilm. The red complex, which is recognized as the most important pathogen in adult periodontal disease, represents 8.08% of the 19 bacteria analyzed. P. gingivalis was detected in 19% of healthy subjects and represents 0.02% of the interdental biofilm. T. forsythensis and T. denticola (0.02 and 0.04% of the interdental biofilm) were detected in 93 and 49% of healthy subjects, respectively. The effective presence of periodontal pathogens is a strong indicator of the need to develop new methods for disrupting interdental biofilm in daily oral hygiene.
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Affiliation(s)
- Florence Carrouel
- Institute of Functional Genomics of Lyon, UMR CNRS 5242, Ecole Normale Supérieure de Lyon, University Lyon 1, Lyon France
| | - Stéphane Viennot
- Laboratory "Health, Individual, Society" EA4129, University Lyon 1, Lyon France
| | - Julie Santamaria
- Department of Prevention and Public Health, Faculty of Dentistry, University Lyon 1, Lyon France
| | - Philippe Veber
- Laboratory "Biométrie et Biologie Évolutive", UMR CNRS 5558 - LBBE, University Lyon 1, Villeurbanne France
| | - Denis Bourgeois
- Laboratory "Health, Individual, Society" EA4129, University Lyon 1, Lyon France
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