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Li Y, Xin C, Xie J, Sun X. Association between visfatin and periodontitis: a systematic review and meta-analysis. PeerJ 2024; 12:e17187. [PMID: 38560458 PMCID: PMC10981885 DOI: 10.7717/peerj.17187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background Periodontitis is a chronic inflammatory disease caused by bacterial infection in the periodontal support tissue. Visfatin, a hormone secreted mainly by adipocytes and macrophages, plays an important role in immune regulation and defense. Although studies have indicated that patients with periodontitis have significantly high serum and gingival crevicular fluid levels of visfatin, the relationship between this adipocytokine and periodontal disease remains unclear. Aim The aim of this study was to systematically evaluate the association between visfatin levels and periodontitis. Methods The PubMed, Web of Science, ScienceDirect, EBSCO, and Wiley Online Library databases were searched for potential studies, using "periodontitis" and "visfatin" as the keywords in the title and abstract search fields. Standardized mean difference (SMD) values with corresponding 95% confidence intervals (CIs) were determined from the results of this meta-analysis. Results In total, 22 articles involving 456 patients with periodontitis and 394 healthy individuals (controls) were included in the meta-analysis. Visfatin levels were significantly higher in the patients with periodontitis than in the healthy individuals (SMD: 3.82, 95% CI [3.01-4.63]). Moreover, the visfatin levels were significantly lowered after periodontitis treatment (SMD: -2.29, 95% CI [-3.33 to -1.26]). Conclusion This first-ever meta-analysis comparing visfatin levels between patients with periodontitis and healthy individuals suggests that this adipocytokine can be a diagnostic and therapeutic biomarker for periodontal disease.
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Affiliation(s)
- Yaoqin Li
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Caihong Xin
- Department of Endocrinology and Metabolism, Fourth People’s Hospital of Shenyang, Shenyang, China
| | - Jing Xie
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Sun
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
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Bayani M, Heidari M, Almasi-Hashiani A. Periodontal disease and visfatin level: A systematic review and meta-analysis. PLoS One 2023; 18:e0293368. [PMID: 37934738 PMCID: PMC10629655 DOI: 10.1371/journal.pone.0293368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/11/2023] [Indexed: 11/09/2023] Open
Abstract
Visfatin is considered an inflammatory biomarker in periodontal disease (PD). In this meta-analysis, we aimed to evaluate the relationship between Visfatin biomarker level with PD. In this study, Medline, Scopus, Web of Science, and Google Scholar were searched. We included studies that examined visfatin levels in samples from healthy people and periodontal disease until March 2023. The quality of the selected articles was evaluated using the Newcastle-Ottawa assessment scale. Depending on heterogeneity of studies, random-effects or fixed-effect models were used to pool results and report the standardized mean difference (SMD). After screening the retrieved papers, the related data were extracted. A total of 159 studies were identified, and 16 studies were included in the meta-analysis. In 9 studies, the SMD of visfatin level of gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) and healthy individuals was 4.32 (p<0.001). In 6 studies, the SMD of salivary visfatin level in patients with CP and healthy individuals was 2.95 (p = 0.004). In addition, in five studies, the SMD of serum visfatin level in patients with CP and healthy individuals was 7.87 (p<0.001). Therefore, Visfatin levels in serum, saliva, and GCF of patients with CP were increased in comparison to healthy individuals. Comparison of visfatin levels in saliva of gingivitis patients and healthy individuals showed a significant increase of visfatin in gingivitis patients (SMD:0.57, P = 0.018), but no significant difference was observed in the mean GCF visfatin level of gingivitis patients and healthy individuals (SMD:2.60, P = 0.090). In addition, the results suggested that there is no difference between gingivitis cases compared to CP patients (SMD:3.59, P = 0.217). Visfatin levels in GCF, serum, and saliva have the potential to be used as a diagnostic biomarker of periodontitis.
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Affiliation(s)
- Mojtaba Bayani
- Department of Periodontics, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | | | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
- Traditional and Complementary Medicine Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Zhu J, Zhang S, Shi J, ning N, Wei Y, Zhang Y. Periodontitis is associated with the increased levels of visfatin: a meta-analysis. BMC Oral Health 2023; 23:799. [PMID: 37884949 PMCID: PMC10601249 DOI: 10.1186/s12903-023-03384-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/04/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Periodontitis is a common inflammatory disease associated with systemic factors. Visfatin is a pleiotropic adipokine that exerts metabolic and immune functions. Studies have shown visfatin played roles in the development of periodontitis. The present study aims to compare the levels of visfatin in body fluids including serum, saliva, and gingival crevicular fluid (GCF) between periodontitis patients and healthy individuals, and to elucidate the alteration of visfatin levels after periodontal treatments. MATERIALS AND METHODS The database searched included Pubmed, Embase, Web of Science, and Cochrane Library. According to the Eligibility criteria, the records were screened and the eligible studies were included. The methodological qualities of the included case-controlled studies were assessed according to the Newcastle-Ottawa scale (NOS). The Methodological Index for Nonrandomized Studies (MINORS) was applied for assessing the qualities of the included clinical trials. The statistical analyses were processed using STATA 15.0. RESULTS Twenty-three studies were included in the statistical analyses. The meta-analysis showed significantly elevated visfatin levels of GCF, serum, and saliva in the periodontitis population compared with the controls (GCF: SMD = 5.201, 95% CI: 3.886-6.516, Z = 7.75, P < 0.05; Serum: SMD = 7.417, 95% CI: 3.068-11.767, Z = 3.34, P = P < 0.05; Saliva: SMD = 2.683, 95% CI: 1.202-4.163, Z = 3.34, P < 0.05). Visfatin levels of saliva serum and GCF were significantly decreased after periodontal treatment. (Saliva: SMD = -1.338, 95% CI: -2.289-0.487, Z = 39.77, P < 0.05; Serum: SMD = -2.890, 95% CI: -5.300-0.480, Z = 2.35, P < 0.05; GCF: SMD = -6.075, 95% CI: -11.032-1.117, Z = 2.40, P = 0.016; I 2 = 95.9%, P < 0.05). CONCLUSIONS Periodontitis elevated the visfatin levels in GCF, serum, and saliva. Additionally, GCF, serum, and saliva visfatin levels could be reduced after periodontal treatment.
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Affiliation(s)
- Junfei Zhu
- Stomatology Center, China Japan Friendship Hospital, Beijing, China
| | - Suhan Zhang
- Department of Dermatology, China Japan Friendship Hospital, Beijing, China
| | - Jing Shi
- The ward of stomatology center, China Japan friendship hospital, Beijing, China
| | - Ning ning
- The ward of stomatology center, China Japan friendship hospital, Beijing, China
| | - Ying Wei
- The Second Department of Proctology, China Japan Friendship Hospital, Beijing, China
| | - Ye Zhang
- Stomatology Center, China Japan Friendship Hospital, Beijing, China
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Hu D, Wang J, Cheng T, Li H, Zhang F, Zhao D, Xu X, Yu R, Wen P, Cheng Y, Xu J, Jin L, Yao J. Comparative analysis of serum and saliva samples using Raman spectroscopy: a high-throughput investigation in patients with polycystic ovary syndrome and periodontitis. BMC Womens Health 2023; 23:522. [PMID: 37794378 PMCID: PMC10552415 DOI: 10.1186/s12905-023-02663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) and periodontitis significantly affect women's oral and systemic health worldwide, and yet increase the risk of cardiovascular-metabolic diseases like diabetes and coronary heart disease. Regarding the PCOS-periodontitis connection, whether sex hormones, metabolic and inflammatory mediators could account for the underlying linking mechanism needs to be further investigated. This case-control study evaluated the hormonal, metabolic and inflammatory profiles in PCOS and non-PCOS subjects with various periodontal conditions, via assessing serum and saliva samples by Raman spectroscopy. METHODS A total of 66 females with PCOS and 22 systemically healthy female volunteers were recruited in a single hospital. Full-mouth periodontal examination was undertaken for identifying the subjects with periodontal health, gingivitis or periodontitis. The datasets of sex hormones and metabolic indicators were retrieved from the hospital information system. Both serum and saliva samples were collected for detecting inflammatory mediators and Raman spectroscopic assessment. The subjects were categorized into four groups according to their conditions of PCOS and periodontitis for Raman spectroscopic analysis. Partial least squares discriminant analysis was performed to examine the inter-group differences in Raman spectra. RESULTS PCOS patients exhibited greater mean probing depth (P < 0.05) and higher serum levels of triglycerides (P < 0.05) and matrix metalloproteinase-8 (P < 0.05) than those in non-PCOS participants. Both probing depth and triglyceride level were positively correlated with PCOS (P < 0.05). There was a significant difference in mean Raman spectra of saliva samples among the four groups with different conditions of PCOS and periodontitis (P < 0.05), while no significant inter-group difference existed in serum samples. CONCLUSIONS The present study shows that periodontal condition may affect the biomolecular profiles of Raman spectra in serum and saliva of PCOS patients. It underscores the importance of the collaborative teamwork of dentists and gynecologists for enhancing women's oral health, general wellbeing and quality of life.
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Affiliation(s)
- Dangli Hu
- Department of Obstetrics & Gynecology, Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, China
| | - Jianmei Wang
- Single-Cell Center, CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics and Shandong Energy Institute, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, 266101, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Tianfan Cheng
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Huijun Li
- Department of Stomatology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, China
| | - Feng Zhang
- Department of Stomatology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, China
| | - Dan Zhao
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Xiaoyi Xu
- Department of Science & Education, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, China
| | - Rong Yu
- Department of Science & Education, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, China
| | - Ping Wen
- Department of Science & Education, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, China
| | - Yunfei Cheng
- Single-Cell Center, CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics and Shandong Energy Institute, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, 266101, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Jian Xu
- Single-Cell Center, CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics and Shandong Energy Institute, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, 266101, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Lijian Jin
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Jilong Yao
- Department of Obstetrics & Gynecology, Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, China.
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Dou Y, Xin J, Zhou P, Tang J, Xie H, Fan W, Zhang Z, Wu D. Bidirectional association between polycystic ovary syndrome and periodontal diseases. Front Endocrinol (Lausanne) 2023; 14:1008675. [PMID: 36755917 PMCID: PMC9899846 DOI: 10.3389/fendo.2023.1008675] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) and periodontal disease (PDD) share common risk factors. The bidirectional interaction between PCOS and PDD has been reported, but until now, the underlying molecular mechanisms remain unclear. Endocrine disorders including hyperandrogenism (HA) and insulin resistance (IR) in PCOS disturb the oral microbial composition and increase the abundance of periodontal pathogens. Additionally, PCOS has a detrimental effect on the periodontal supportive tissues, including gingiva, periodontal ligament, and alveolar bone. Systemic low-grade inflammation status, especially obesity, persistent immune imbalance, and oxidative stress induced by PCOS exacerbate the progression of PDD. Simultaneously, PDD might increase the risk of PCOS through disturbing the gut microbiota composition and inducing low-grade inflammation and oxidative stress. In addition, genetic or epigenetic predisposition and lower socioeconomic status are the common risk factors for both diseases. In this review, we will present the latest evidence of the bidirectional association between PCOS and PDD from epidemiological, mechanistic, and interventional studies. A deep understanding on their bidirectional association will be beneficial to provide novel strategies for the treatment of PCOS and PDD.
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Affiliation(s)
- Yang Dou
- Department of Stomatology, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Jinglei Xin
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Peng Zhou
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Jianming Tang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Hongliang Xie
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Wanting Fan
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Zheng Zhang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Donglei Wu
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Donglei Wu,
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Wu P, Zhang X, Zhou P, Zhang W, Li D, Lv M, Liao X. Assessment of Bidirectional Relationships Between Polycystic Ovary Syndrome and Periodontitis: Insights From a Mendelian Randomization Analysis. Front Genet 2021; 12:644101. [PMID: 33868379 PMCID: PMC8044848 DOI: 10.3389/fgene.2021.644101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Observational studies have indicated an association between polycystic ovary syndrome (PCOS) and periodontitis, but it is unclear whether the association is cofounded or causal. We conducted a two-sample Mendelian randomization (MR) study to investigate the bidirectional relationship between genetically predicted PCOS and periodontitis. Methods From two genome-wide association studies we selected 13 and 7 single nucleotide polymorphisms associated with PCOS and periodontitis, respectively, as instrumental variables. We utilized publicly shared summary-level statistics from European-ancestry cohorts. To explore the causal effect of PCOS on periodontitis, 12,289 cases of periodontitis and 22,326 controls were incorporated, while 4,890 cases of PCOS and 20,405 controls in the reverse MR. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined PCOS was not causally associated with risk of periodontitis (odds ratio 0.97; 95% confidence interval 0.88-1.06; P = 0.50) per one-unit increase in the log-odds ratio of periodontitis. Similarly, no causal effect of periodontitis on PCOS was shown with the odds ratio for PCOS was 1.17 (95% confidence interval 0.91-1.49; P = 0.21) per one-unit increase in the log-odds ratio of periodontitis. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion The bidirectional MR study couldn't provide convincing evidence for the causal relationship between genetic liability to PCOS and periodontitis in the Europeans. Triangulating evidence across further observational and genetic-epidemiological studies is necessary.
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Affiliation(s)
- Pengfei Wu
- Hunan Key Laboratory of Animal Models for Human Diseases, Department of Laboratory Animals, Third Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Center for Medical Genetics, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ping Zhou
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wan Zhang
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Danyang Li
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Mingming Lv
- Department of Oral Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaoyao Liao
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
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Intergenerational effects of pre-pregnancy chronic lipopolysaccharide from Porphyromonas gingivalis on the learning, memory and seizure susceptibility of offspring. Arch Oral Biol 2021; 125:105076. [PMID: 33636410 DOI: 10.1016/j.archoralbio.2021.105076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of pre-pregnancy chronic exposure to Porphyromonas gingivalis LPS (Pg LPS) on the learning, memory, and seizure susceptibility of the offspring. DESIGN To achieve periodontitis, Pg LPS (5 μg/kg) was injected into the gingival of five female rats every 48 h for three weeks. Five control female rats received saline (0.9 %) and five female were kept intact. The concentrations of TNF-α and IL-6 were measured in the blood samples. One week after the final injection, females were mated with intact males. Following birth and weaning, two male and two female offspring were randomly selected from each mother, and new groups of male and female offspring were defined for behavioral assessments. Morris water maze was used to evaluate spatial memory, shuttle box was used to investigate avoidance memory and a pentylenetetrazole-induced seizure was used to evaluate seizure susceptibility in the offspring. RESULTS Spatial learning and avoidance memory significantly decreased in both male and female offspring of Pg LPS-exposed female rats, compared to the control offspring. Latency to reach seizure stages 1 and 2 significantly increased in the male offspring, but not the female offspring of Pg LPS-exposed female, compared to the control offspring. However, no significant difference was found in latency to reach stages 3-5. CONCLUSION Pre-pregnancy exposure to Pg LPS could affect some behavioral functions in both male and female offspring intergenerationally.
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Machado V, Botelho J, Proença L, Mendes JJ. Comparisons of Periodontal Status between Females Referenced for Fertility Treatment and Fertile Counterparts: A Pilot Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5281. [PMID: 32707937 PMCID: PMC7432159 DOI: 10.3390/ijerph17155281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/20/2022]
Abstract
Studies investigating the periodontal status of women seeking fertility treatment have never been conducted. The purpose of this pilot study was to compare the periodontal status among females referenced to a Fertility Clinic (FC) when compared to matched females from a representative regional epidemiological sample. Our secondary aims were to investigate if periodontal clinical measures differ between these two groups of females and how they impact on oral health-related quality of life (OHRQoL). We enrolled 18 women from an FC and 18 age, race and body mass index matched controls from the epidemiological survey Study of Periodontal Health in Almada-Seixal (SoPHiAS). In each subject, we performed a circumferential periodontal inspection to infer the periodontal status and applied a questionnaire measuring OHRQoL. FC females presented higher levels of periodontal disease, with higher periodontal epithelial surface area, periodontal probing depth and clinical attachment loss. However, periodontal diseases did not impact OHRQoL in this particular group of women seeking fertility care, suggesting unawareness about periodontal diseases. Within the limitations of this study, females referenced for fertility treatment presented worse periodontal measures than females from a representative control sample. These preliminary results may support future prospective studies to further explore the periodontal status and possible consequences in women seeking fertility care.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - José João Mendes
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
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Machado V, Escalda C, Proença L, Mendes JJ, Botelho J. Is There a Bidirectional Association between Polycystic Ovarian Syndrome and Periodontitis? A Systematic Review and Meta-analysis. J Clin Med 2020; 9:jcm9061961. [PMID: 32585861 PMCID: PMC7355910 DOI: 10.3390/jcm9061961] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) has reproductive and metabolic properties that may be linked to periodontitis (PD). This study aimed to update and render a robust critical assessment on all evidence linking PCOS and PD, and appraising a hypothetical bidirectional association. Five databases (PubMed, Scholar, EMBASE, Web of Science and CENTRAL) were searched up to May 2020. Case-control and cohort studies on the association of PCOS and PD were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses of standardized mean difference (SMD) and risk ratio (RR) were performed. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Twelve case-controls fulfilled the inclusion criteria (876 with PCOS and 48170 healthy controls), all scored as having a low risk of bias. Meta-analysis revealed that PCOS females have 28% more risk towards PD, and PD females have 46% more risk to have PCOS. PCOS females with PD had higher gum bleeding, periodontal pocket depth and clinical attachment loss than non-PCOS females with PD. Populations with undefined periodontal status contribute to underestimated results. On the basis of the available evidence, it is possible to assume a bidirectional link between PCOS and PD. That is, PCOS increases by 28% the risk of having PD and in the same fashion, PD increases by 46% the risk of having PCOS. Furthermore, women with PCOS were associated with worsening clinical characteristics and inflammation of PD. These findings suggest that PCOS and PD may be linked. Hence, further prospective and clinical trial studies with nonsurgical periodontal therapy are necessary to clarify the existence of an increased risk of PCOS in women with PD and vice-versa.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
- Correspondence:
| | - Cláudia Escalda
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
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