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Kosho MXF, Verhelst ARE, Teeuw WJ, van Bruchem S, Nazmi K, Gerdes VEA, Loos BG. The Prevalence of Metabolic Syndrome and Undiagnosed Diabetes in Periodontitis Patients and Non-Periodontitis Controls in a Dental School. J Clin Med 2024; 13:7512. [PMID: 39768434 PMCID: PMC11676694 DOI: 10.3390/jcm13247512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 11/25/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025] Open
Abstract
Background/Objectives: Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are major global health concerns, and they often go undetected. Periodontitis shares risk factors and is associated with both conditions. Assessing MetS risk factors among dental patients, especially those with periodontitis, may contribute to early detection and prompt treatment. However, current information about MetS prevalence rates in dental settings is limited. Therefore, our aim was to investigate the prevalence of MetS among patients with generalized periodontitis stage III/IV (GenPD), localized periodontitis stage III/IV (LocPD), and non-periodontitis controls. We also investigated the prevalence of undiagnosed T2DM in the same population. Moreover, we performed a pilot study to evaluate the possibility of measuring fructosamine levels in oral rinse samples, as an alternative to HbA1c, to screen for hyperglycemia. Methods: Periodontitis patients and non-periodontitis controls were recruited from a dental school, all aged ≥ 40 years. MetS prevalence was determined according to four different MetS definitions. T2DM prevalence was based on elevated HbA1c levels (HbA1c ≥ 7.0%). Biochemical analysis from blood was carried out by finger stick sampling. A subset of participants was asked to provide an oral rinse sample for the measurement of fructosamine, which was correlated to HbA1c from blood. Results: A total of 105 patients with periodontitis (GenPD stage III/IV: n = 44, LocPD stage III/IV: n = 61) and 88 non-periodontitis controls, with a mean age of 54.4 years, were included. The prevalence of MetS, according to four different MetS definitions, was 68.2-81.8% in GenPD patients, 42.6-62.3% in LocPD patients, and 52.3-69.3% in controls. The prevalence of T2DM, as evidenced by elevated HbA1c, was 20.5% in GenPD patients, 18.3% in LocPD patients, and 10.2% in controls (p = 0.094). A substantial number of subjects were not aware that they were being suspected to have T2DM, i.e., 13.6% in GenPD patients, 8.2% in LocPD patients, and 8.0% in controls (p = 0.335). In a subset of participants (n = 48), we found no significant correlation between HbA1c and oral fructosamine (r= 0.24, p = 0.103). Conclusions: The overall results showed a relatively high prevalence of patients with MetS and/or elevated HbA1c among periodontitis patients and controls in the dental school. Of those with suspected T2DM, a substantial number were not aware of having T2DM. Oral health care professionals could therefore contribute to early detection for T2DM and/or create awareness in patients at risk for a disease related to MetS. To date, initial results on the use of oral fructosamine as an alternative for HbA1c cast doubt, and further research is needed.
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Affiliation(s)
- Madeline X. F. Kosho
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.R.E.V.); (W.J.T.); (S.v.B.); (B.G.L.)
| | - Alexander R. E. Verhelst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.R.E.V.); (W.J.T.); (S.v.B.); (B.G.L.)
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.R.E.V.); (W.J.T.); (S.v.B.); (B.G.L.)
| | - Sebastiaan van Bruchem
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.R.E.V.); (W.J.T.); (S.v.B.); (B.G.L.)
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Centre (AUMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
- Department of Internal Medicine, Spaarne Gasthuis, 2134 TM Hoofddorp, The Netherlands
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.R.E.V.); (W.J.T.); (S.v.B.); (B.G.L.)
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Sayeed G, Varghese SS. Evaluation of the Effect of Supragingival Scaling on Periodontal Parameters in Pregnant Women with Metabolic Syndrome. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S3925-S3931. [PMID: 39927038 PMCID: PMC11805228 DOI: 10.4103/jpbs.jpbs_1372_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 10/15/2024] [Accepted: 10/21/2024] [Indexed: 02/11/2025] Open
Abstract
Background Although there are quite a number of studies on the impacts of periodontal therapeutic management on pregnant females, literature on the impact of supragingival scaling on pregnant females with metabolic syndrome (MS) is wanting. The present investigation was meticulously formulated to ascertain the clinical ramifications of supragingival scaling in pregnant individuals diagnosed with MS. Material and Methods An intervention study was conducted on 47 pregnant females. The gingival index (GI), plaque index, bleeding on probing, probing depth, and clinical attachment level were among the periodontal parameters evaluated. By the end of 20-21 weeks of pregnancy, all participants had received scaling and polishing at the baseline appointment, along with advice on dental hygiene. Periodontal parameters were gathered again during a follow-up appointment 8 weeks post treatment. A 5% threshold for statistical significance was set, and paired t-test and chi-square test were applied for comparison. Results Lower levels of PI, GI, and BOP 8 weeks post supragingival scaling were noted than at the baseline. The results obtained were statistically significant (P < 0.001) All patients with severe periodontitis (n = 14) before supragingival scaling shifted to milder forms of the disease. Similarly, moderate periodontitis was seen in 20 patients before the start of the study, and after the intervention, it was reduced to 16 patients. Conclusion In summary, supragingival scaling lowers the incidence of periodontal disease in pregnant MS females. High-risk pregnant women who receive scaling treatment and instruction on oral hygiene on a regular basis have better oral health, which in turn improves the health of their unborn child.
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Affiliation(s)
- Ghousia Sayeed
- Department of Preventive Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Sheeja S. Varghese
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Dinu A, Antonescu OR. Clinical Study on the Implications of Immunological Markers in the Diagnosis of Periodontitis in People with Diabetes Mellitus. Dent J (Basel) 2024; 12:149. [PMID: 38920850 PMCID: PMC11202785 DOI: 10.3390/dj12060149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/29/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024] Open
Abstract
The basic idea from which the working hypothesis for this study started is the fact that the only systemic disease today that is clearly linked to periodontal disease by biochemical mechanisms is diabetes mellitus, as well as the clinical finding that diabetes causes a number of specific periodontal changes. Highlighting the biochemical markers of inflammation during periodontal disease in patients diagnosed with type 2 diabetes is the main aim of the study. To achieve this objective, we used the human ELISA kit from Boster Biological Technology Co., Ltd. (Pleasanton, CA, USA), for the detection of IL-1β, IL-4, IL-8 and TNF-α. The data analysis shows that plasma levels of these cytokines are associated with the progression of periodontitis. In conclusion, we can state that the involvement of immunological markers is evident in the pathogenesis of periodontal disease.
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Affiliation(s)
- Andreea Dinu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania;
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Gürbüz S, Altıkat M. The association between periodontitis patients' chief complaints and the stage of periodontitis: A clinical retrospective study. Clin Oral Investig 2023; 27:6261-6272. [PMID: 37704915 DOI: 10.1007/s00784-023-05258-x] [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: 02/12/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES The purposes of this retrospective study were to investigate the prevalence of various periodontal chief complaints (pCCs) of patients, diagnosed with periodontitis, as well as to identify the association between pCCs and periodontal parameters or periodontitis staging according to AAP/EFP 2017 classification. MATERIALS AND METHODS Five hundred eighty-nine patients, applied to the clinic with pCCs, were screened. The demographic characteristics, smoking status, brushing behaviors, history of periodontal therapy, medical data, and periodontal parameters were obtained. A multinomial logistic regression analysis was performed to determine the most common pCCs and co-variables among the indicators of Stage III and IV periodontitis. RESULTS In Stage IV periodontitis, patients with pCC of mobility were observed the most (26.8%), and pCC of halitosis were the least (7.3%). Among all pCCs of patients, those with the pCC of gingival enlargement and tooth mobility had the highest percentage of sites with PPD ≥ 4 mm and CAL ≥ 5 mm, respectively (p < .001). According to regression analysis, those with pCC of gingival bleeding, recession and mobility were more likely to be in Stage IV than those in Stage I/II. CONCLUSION Among pCCs, only patients with pCCs of mobility, gingival recession and bleeding are related to periodontitis staging. Moreover, the extent of periodontal pockets in patients with pCC of gingival enlargement, and the extent of attachment loss in patients with pCC of mobility are greater than other patients. CLINICAL RELEVANCE New machine-learning technology models can be developed with the aim of classifying the patients based on their chief complaints, to support diagnosing the severity of periodontal diseases.
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Affiliation(s)
- Sühan Gürbüz
- Department of Periodontology, Gazi University Faculty of Dentistry, Bişkek Caddesi, 1.Sokak No. 4, 06490, Ankara, Türkiye.
| | - Merve Altıkat
- Vocational School of Health Care Services, İstinye University, İstanbul, Türkiye
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Nilsen A, Thorsnes A, Lie SA, Methlie P, Bunaes DF, Reinholtsen KK, Leknes KN. Periodontitis in obese adults with and without metabolic syndrome: a cross-sectional study. BMC Oral Health 2023; 23:439. [PMID: 37393272 PMCID: PMC10315020 DOI: 10.1186/s12903-023-03133-5] [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: 03/23/2023] [Accepted: 06/14/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Epidemiological studies support an association between obesity, metabolic syndrome (MetS), and periodontitis. Still, understanding of the effects of low-grade inflammation in obese subjects on periodontitis and influence of MetS remains incomplete. The aims of this cross-sectional study were to explore the association between obesity related variables and periodontitis, and assess if MetS is a risk indicator for periodontitis in a sample of obese adults. METHODS The study sample comprised 52 adults with a body mass index (BMI) of ≥ 30 kg/m2 referred for obesity therapy at the Obesity Centre at Haukeland University Hospital (HUH), Bergen, Norway. The subjects had prior to enrolment completed a 5-month lifestyle intervention course as part of a 2-year managing program. According to the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) classification of MetS, 38 subjects were recruited to the MetS group and 14 subjects to the non-MetS group. Medical data including peripheral blood samples were obtained from records at HUH at the time of enrolment. Probing depth, clinical attachment level, tooth mobility, furcation involvement, bleeding on probing (BoP) were recorded and intraoral bitewings evaluated at a full-mouth periodontal examination. Associations between risk variables for obesity/MetS and periodontitis were explored using linear and logistic regression models. RESULTS In the present sample 79% of the subjects were diagnosed with periodontitis. The prevalence of stage III/IV periodontitis was 42.9% in the non-MetS group vs. 36.8% in the MetS group (p = 0.200). In the non-MetS group 29.8% of the sites displayed BoP vs. 23.5% in the MetS group (p = 0.048). For stage III/IV periodontitis, the effect of age appeared to be significant for obesity related variables and MetS (p = 0.006, p = 0.002, respectively). None of the other analyses showed significant association with the outcome variables. CONCLUSION In the present sample of obese subjects, periodontitis occurred independently of MetS. Reaching a certain BMI level, suggested association between MetS and periodontitis might be non-significant due to the dominating impact of obesity related variables undermining the effect of other systemic factors. TRIAL REGISTRATION The principal clinical trial, entitled "Obesity and Oral Diseases", was prospectively registered in ClinicalTrials.gov with registration NCT04602572 (20.10.2020).
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Affiliation(s)
- Astrid Nilsen
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Anette Thorsnes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Paal Methlie
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Dagmar F Bunaes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Karen K Reinholtsen
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Knut N Leknes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway.
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Kuraji R, Shiba T, Dong TS, Numabe Y, Kapila YL. Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J Gastroenterol 2023; 29:967-996. [PMID: 36844143 PMCID: PMC9950865 DOI: 10.3748/wjg.v29.i6.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/14/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
A growing body of evidence from multiple areas proposes that periodontal disease, accompanied by oral inflammation and pathological changes in the microbiome, induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). A subgroup of NAFLD patients have a severely progressive form, namely nonalcoholic steatohepatitis (NASH), which is characterized by histological findings that include inflammatory cell infiltration and fibrosis. NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma. The oral microbiota may serve as an endogenous reservoir for gut microbiota, and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis. Gut dysbiosis increases the production of potential hepatotoxins, including lipopolysaccharide, ethanol, and other volatile organic compounds such as acetone, phenol and cyclopentane. Moreover, gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall, leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation. In particular, many animal studies support that oral administration of Porphyromonas gingivalis, a typical periodontopathic bacterium, induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis. NAFLD, also known as the hepatic phenotype of metabolic syndrome, is strongly associated with metabolic complications, such as obesity and diabetes. Periodontal disease also has a bidirectional relationship with metabolic syndrome, and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively. In this review, we will describe the link between periodontal disease and NAFLD with a focus on basic, epidemiological, and clinical studies, and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome. In conclusion, it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease, gut microbiota, and metabolic syndrome. Thus, the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics, prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-0071, Japan
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Takahiko Shiba
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tien S Dong
- The Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Department of Medicine, University of California David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-8159, Japan
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
- Sections of Biosystems and Function and Periodontics, Professor and Associate Dean of Research, Felix and Mildred Yip Endowed Chair in Dentistry, University of California Los Angeles, Los Angeles, CA 90095, United States
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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: 1.0] [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; 19:14536. [PMID: 36361416 PMCID: PMC9657467 DOI: 10.3390/ijerph192114536] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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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Affiliation(s)
- Sameena Parveen
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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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: 12] [Impact Index Per Article: 4.0] [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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Kotin J, Walther C, Wenzel U, Zyriax BC, Borof K, Schnabel RB, Seedorf U, Jagodzinski A, Heydecke G, Lamprecht R, Smeets R, Beikler T, Aarabi G. Association between periodontitis and the metabolic syndrome in the Hamburg City Health Study. J Periodontol 2021; 93:1150-1160. [PMID: 34967009 DOI: 10.1002/jper.21-0464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies demonstrated an association between severe chronic periodontitis (CP) and the metabolic syndrome (MetS). However, these studies mostly employed the meanwhile outdated NCEP-ATPIII case definition of the MetS. Additionally, CP was rarely diagnosed based on a full-mouth examination. Thus, the aim of the current study was to re-evaluate the potential association between CP and the MetS in the Hamburg City Health Study (HCHS), a large population-based survey of middle-aged and elderly men and women in Germany, in view of more current definitions of the MetS and CP. METHODS A cross-sectional study was performed with baseline-data from participants of the Hamburg City Health Study (HCHS). Periodontitis severity grades were determined in a random sample of 6,209 participants of which 5,456 had sufficient data to call absence or presence of the MetS. Variables defining the MetS according to the currently valid harmonized definition were determined and a full-mouth examination was performed, including determination of the clinical attachment loss (AL), bleeding on probing (BOP), and dental plaque (PI) index. CP was classified in three grades of severity (none/mild, moderate, and severe). The Kruskal-Wallis test or the Chi-squared test were used for descriptive statistics and multivariate logistic regression models with and without adjustments for potential confounders (age, sex, smoking, high sensitivity C-reactive protein (hsCRP), energy intake, and physical activity) were used to test for associations. RESULTS The prevalence of the MetS (39.0%) increased according to the severity grades of periodontitis (none/mild: 33.6%; moderate: 38.7%, and severe: 46.8%). Multivariate logistic regression analyses demonstrated that severe but not moderate CP was associated with the MetS after adjusting for age and sex (odds ratio [OR]: 1.24; 95% confidence interval [CI]: 1.03-1.48; p = 0.02). However, the association was attenuated after additional adjustment for smoking (OR: 1.19; 95% CI: 0.99-1.43; p = 0.058) and hsCRP, energy intake, and physical activity (OR: 1.11; 95% CI 0.91-1.36; p = 0.294). CONCLUSIONS The use of the more current definitions for the MetS and CP confirmed previous observations of an age- and sex-adjusted association between severe CP and the MetS. Smoking, high energy intake and low physical activity were identified as important lifestyle-related confounders. Abdominal obesity, as indicated by elevated waist circumference, came out as the most important component of the MetS in relation to CP. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jennifer Kotin
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Wenzel
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science - Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Epidemiological Study Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Renate B Schnabel
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annika Jagodzinski
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ragna Lamprecht
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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11
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Kim JI, Choi CH, Chung KH. No Association between Metabolic Syndrome and Periodontitis in Korean Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11110. [PMID: 34769630 PMCID: PMC8583674 DOI: 10.3390/ijerph182111110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to determine the association between metabolic syndrome (MetS) and periodontitis in Korean postmenopausal women. The study selected 3320 menopause women (40-79-year-old) from those who participated in the seventh Korea National Health and Nutrition Survey (2016-2018). This association was determined using frequency and multiple logistic regression analyses. The prevalence of MetS in postmenopausal women was 33.2%, and among the MetS components, abdominal obesity showed a higher odds ratio of periodontitis by 1.36 (95% confidence interval (CI): 1.12-1.65; p < 0.05). The odds ratio for periodontitis was 1.34 times higher (95% CI: 1.12-1.60) in the MetS prevalence group with three or more MetS components (p < 0.05); however, after adjusting for demographic characteristics and health behavior variables, it was not statistically significant. Therefore, our results indicated that MetS has no association with periodontitis in postmenopausal women after adjusting for confounding variables.
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Affiliation(s)
- Jeong-In Kim
- Department of Preventive & Public Health Dentistry, Chonnam National University, Gwangju 61186, Korea; (J.-I.K.); (C.-H.C.)
| | - Choong-Ho Choi
- Department of Preventive & Public Health Dentistry, Chonnam National University, Gwangju 61186, Korea; (J.-I.K.); (C.-H.C.)
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju 61186, Korea
| | - Ki-Ho Chung
- Department of Preventive & Public Health Dentistry, Chonnam National University, Gwangju 61186, Korea; (J.-I.K.); (C.-H.C.)
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju 61186, Korea
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12
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Tsai KZ, Su FY, Cheng WC, Huang RY, Lin YP, Lin GM. Associations between metabolic biomarkers and localized stage II/III periodontitis in young adults: The CHIEF Oral Health study. J Clin Periodontol 2021; 48:1549-1558. [PMID: 34605054 DOI: 10.1111/jcpe.13555] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 12/13/2022]
Abstract
AIM To investigate the associations between metabolic risk factors and periodontitis in young adults. MATERIALS AND METHODS The study included 1123 participants, aged 19-40 years, in Taiwan. Metabolic syndrome components were defined by the International Diabetes Federation criteria. Localized periodontitis was graded to healthy (n = 828) and stage II/III (n = 295) according to the 2017 criteria of the World Workshop. Multiple logistic regression analysis with adjustment for sex, age, betel nut consumption, and smoking were used to determine the associations. RESULTS Greater waist circumference, serum triglycerides, and serum uric acid were associated with higher localized stage II/III periodontitis risk [odds ratio (OR) and 95% confidence interval (CI): 1.04 (1.02-1.05), 1.004 (1.002-1.006), and 1.10 (1.00-1.21), respectively]. There were no associations for total cholesterol, high-density lipoprotein, and blood pressure. There was a non-linear association between fasting glucose and localized stage II/III periodontitis, where the turning point was 105 mg/dl [OR: 0.97 (0.95-0.99) and 1.06 (1.00-1.13) when the levels were <105 and ≥105 mg/dl, respectively]. CONCLUSIONS The risks of localized stage II/III periodontitis vary with metabolic components, in which waist circumference, serum triglycerides, and serum uric acid are the risk factors, whereas plasma glucose shows a non-linear relationship in young adults.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan.,School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Ying Su
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Wan-Chien Cheng
- Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan.,School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Ren-Yeong Huang
- Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan.,School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu-Chi Hospital, New Taipei, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.,Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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13
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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: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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14
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Gesteiro E, Megía A, Guadalupe-Grau A, Fernandez-Veledo S, Vendrell J, González-Gross M. Early identification of metabolic syndrome risk: A review of reviews and proposal for defining pre-metabolic syndrome status. Nutr Metab Cardiovasc Dis 2021; 31:2557-2574. [PMID: 34244048 DOI: 10.1016/j.numecd.2021.05.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/05/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
AIMS a) To analyze the relationship of known and emerging biomarkers/indicators for early risk identification of cardiometabolic health risk; b) to identify early risk markers to be used in both clinical and nonclinical settings; and c) to propose a definition of early risk identification in terms of pre-metabolic syndrome (PreMetSyn). DATA SYNTHESIS Pubmed/Medline, Web of Science, Embase, and Cochrane were searched for Systematic Reviews and Meta-analysis. Selected studies were evaluated, and relevant data were extracted and synthesized. CONCLUSIONS Serum uric acid is a good predictive biomarker of metabolic syndrome (MetSyn) and has been associated with non-alcoholic liver fat disease (NAFLD) and type 2 diabetes. NAFLD emerges as an early risk indicator of PreMetSyn by itself. Muscle strength should also be included as an early risk marker of cardiometabolic health. High serum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually linked to MetSyn showed limited evidence as robust biomarkers for PreMetSyn. Authors suggest defining PreMetSyn related to cardiometabolic risk. It is also necessary to determine how close people are to the cut-off point of MetSyn components, including emerging indicators proposed by our review. Some biomarkers could be used as indicators of PreMetSyn, before any of the MetSyn components appear, allowing early health interventions to prevent its development. Defining a PreMetSyn status might consider both emerging indicators and those variables already included in the definition of MetSyn. New indicators should be considered to create a new risk score specifically meant for PreMetSyn.
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Affiliation(s)
- Eva Gesteiro
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain.
| | - Ana Megía
- Hospital Universitari de Tarragona Joan XXIII-Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III, Madrid, Spain; Rovira i Virgili University, Tarragona, Spain
| | - Amelia Guadalupe-Grau
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain.
| | - Sonia Fernandez-Veledo
- Hospital Universitari de Tarragona Joan XXIII-Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Vendrell
- Hospital Universitari de Tarragona Joan XXIII-Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III, Madrid, Spain; Rovira i Virgili University, Tarragona, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN)-Instituto de Salud Carlos III, Madrid, Spain
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15
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Hernández HG, Hernández-Castañeda AA, Pieschacón MP, Arboleda H. ZNF718, HOXA4, and ZFP57 are differentially methylated in periodontitis in comparison with periodontal health: Epigenome-wide DNA methylation pilot study. J Periodontal Res 2021; 56:710-725. [PMID: 33660869 DOI: 10.1111/jre.12868] [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: 07/30/2020] [Revised: 02/07/2021] [Accepted: 02/14/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the differences in the epigenomic patterns of DNA methylation in peripheral leukocytes between patients with periodontitis and gingivally healthy controls evaluating its functional meaning by functional enrichment analysis. BACKGROUND The DNA methylation profiling of peripheral leukocytes as immune-related tissue potentially relevant as a source of biomarkers between periodontitis patients and gingivally healthy subjects has not been investigated. METHODS A DNA methylation epigenome-wide study of peripheral leukocytes was conducted using the Illumina MethylationEPIC platform in sixteen subjects, eight diagnosed with periodontitis patients and eight age-matched and sex-matched periodontally healthy controls. A trained periodontist performed the clinical evaluation. Global DNA methylation was estimated using methylation-sensitive high-resolution melting in LINE1. Routine cell count cytometry and metabolic laboratory tests were also performed. The analysis of differentially methylated positions (DMPs) and differentially methylated regions (DMRs) was made using R/Bioconductor environment considering leukocyte populations assessed in both routine cell counts and using the FlowSorted.Blood.EPIC package. Finally, a DMP and DMR intersection analysis was performed. Functional enrichment analysis was carried out with the differentially methylated genes found in DMP. RESULTS DMP analysis identified 81 differentially hypermethylated genes and 21 differentially hypomethylated genes. Importantly, the intersection analysis showed that zinc finger protein 718 (ZNF718) and homeobox A4 (HOXA4) were differentially hypermethylated and zinc finger protein 57 (ZFP57) was differentially hypomethylated in periodontitis. The functional enrichment analysis found clearly immune-related ontologies such as "detection of bacterium" and "antigen processing and presentation." CONCLUSION The results of this study propose three new periodontitis-related genes: ZNF718, HOXA4, and ZFP57 but also evidence the suitability and relevance of studying leukocytes' DNA methylome for biological interpretation of systemic immune-related epigenetic patterns in periodontitis.
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Affiliation(s)
- Hernán G Hernández
- Faculty of Dentistry, Division of Health Sciences, Universidad Santo Tomás, Bucaramanga, Colombia
| | | | - Maria P Pieschacón
- Faculty of Dentistry, Division of Health Sciences, Universidad Santo Tomás, Bucaramanga, Colombia
| | - Humberto Arboleda
- Neurosciences Research Group, Faculty of Medicine and Genetic Institute, Universidad Nacional de Colombia, Bogotá, Colombia
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16
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González-Navarro B, Segura-Egea JJ, Estrugo-Devesa A, Pintó-Sala X, Jane-Salas E, Jiménez-Sánchez MC, Cabanillas-Balsera D, López-López J. Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9103205. [PMID: 33020413 PMCID: PMC7600401 DOI: 10.3390/jcm9103205] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/23/2022] Open
Abstract
Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.
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Affiliation(s)
- Beatriz González-Navarro
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
| | - Albert Estrugo-Devesa
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Pintó-Sala
- Vascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, 08970 L’Hospitalet de Llobregat, Barcelona, Spain;
| | - Enric Jane-Salas
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mari Carmen Jiménez-Sánchez
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - José López-López
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Head of the Odontological Hospital University of Barcelona, University of Barcelona, 08970 L’Hospitalet de LLobregat, Barcelona, Spain
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
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17
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Bandiwadekar AS, Shanbhag N, Madhuniranjanswamy MS, Khanagar SB, Naik S, Siddeeqh S. Association of Periodontitis With Metabolic Syndrome: A Case-Control Study. J Int Soc Prev Community Dent 2020; 10:458-465. [PMID: 33042888 PMCID: PMC7523929 DOI: 10.4103/jispcd.jispcd_91_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/22/2020] [Indexed: 12/30/2022] Open
Abstract
Aim: This study was undertaken to assess the association between periodontitis and metabolic syndrome. Materials and Methods: A case-control study was designed among 100 cases as patients with metabolic syndrome aged 35–74 years, and age- and sex-matched 100 controls as apparently healthy relatives or friends accompanying the cases visiting the diabetic outpatient department at Victoria Hospital, Bengaluru, Karnataka, India, using convenience sampling method. Information related to diabetes, hypertension, and oral hygiene practices was collected. Periodontal health status was measured using community periodontal index. Metabolic syndrome was diagnosed based on the criteria of National Cholesterol Education Program Adult Treatment Panel III. Chi-square test and logistic regression were used for analysis. Results: Significantly more number of cases had shallow pockets 4–5 mm, deep pockets ≥ 6 mm, and also more number of loss of attachment code 1, code 2, code 3, and code 4 compared to controls. Bivariate analysis showed significant association between metabolic syndrome and body mass index, smoking, and tobacco chewing. The association between periodontitis and metabolic syndrome was significant with increased risk of developing metabolic syndrome among the subjects with community periodontal index code 3 and code 4 (odds ratio [OR] = 17) and among the subjects having loss of attachment code 1, code 2, code 3, and code 4 (OR = 12). Association remained significant even after adjustment with other variables (adjusted OR = 6). Conclusion: This study showed significant association between periodontitis and metabolic syndrome. Further prospective and randomized control trials are recommended to assess causal association between these two diseases.
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Affiliation(s)
| | - Namita Shanbhag
- Public Health Dentistry Department, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | | | - Sanjeev Balappa Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
| | - Sachin Naik
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Salman Siddeeqh
- Maxillofacial Surgery and Diagnostic Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
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