Periodontal disease linked to metabolic syndrome

NEW YORK (Reuters Health), Dec 2 - In middle-aged adults, gum disease goes hand in hand with the metabolic syndrome, U.K. researchers report.

"Further studies are required to test whether improvements in oral health could affect the onset/progression of the metabolic syndrome or vice versa," Dr. Francesco D'Aiuto of the UCL Eastman Dental Institute in London, one of the researchers on the study, told Reuters Health.

Metabolic syndrome is a cluster of risk factors for heart disease, stroke, and diabetes -- including high blood pressure, abdominal obesity, high blood sugar, low levels of "good" HDL cholesterol, and high triglycerides (another type of blood fat). The syndrome is usually diagnosed when a person has three or more of these traits.

Several studies have suggested links between periodontitis, an infection of the tissue supporting the teeth seen in up to 40% of adults, and system-wide problems such as low grade inflammation and a reduced ability to metabolize glucose (sugar), D'Aiuto and his team note in the Journal of Clinical Endocrinology and Metabolism.

People with periodontitis are also at about 20% greater risk of heart disease. As both periodontitis and the metabolic syndrome have been linked to inflammation and resistance to insulin, they sought to determine whether the two might be directly related.

To investigate, they looked at 13,994 men and women participating in the Third National Health and Nutrition Examination Survey who had undergone periodontal exams.

Thirty-four percent of people with moderate periodontitis and 37% with severe periodontitis had the metabolic syndrome, the researchers found, compared to just 18% of people with no gum disease or only mild periodontitis.

The likelihood of being diagnosed with metabolic syndrome rose with the severity of bleeding in the gums, as well as the proportion of periodontal pockets, or abnormally deep spaces between teeth and gums. The relationship was especially strong among people 40 and older.

After adjusting for factors that might influence the results, adults older than age 45 suffering from severe periodontitis were 2.3 times more likely to have metabolic syndrome than unaffected individuals.

It's still not entirely clear how gum disease and heart disease might be related, D'Aiuto and his colleagues at University College London note, although they point out that they recently found treating severe periodontitis resulted in better blood vessel function six months later.

Regardless, D'Aiuto said, the findings underscore the importance of oral health to general well being, adding that everyone should take care of their gums and teeth and be sure to see a dentist regularly.

By Anne Harding

Source: Journal of Clinical Endocrinology and Metabolism, October 2008.

Last Updated: 2008-11-27 8:01:22 -0400 (Reuters Health)

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