Table 5.

Associations between metabolic syndrome (MetS) and periodontal disease

Reference number	Study conclusions	Results/odds ratio
43	In a longitudinal study, MetS was a predictor of tooth loss and worsening periodontal disease in men. While the associations were slightly stronger according to the IDF criteria, evidence of a relationship between MetS and periodontal disease outcomes was also apparent according to NCEP ATP III criteria	As defined by IDF criteria, MetS increased hazard ratios for tooth loss (1.39), PPD ≥ 5 mm (1.37), CAL (1.19), alveolar bone loss (1.25) and tooth mobility ≥0.5 mm (1.43). As defined by NCEP ATP III criteria, MetS increased hazard ratios for tooth loss (1.44), PPD ≥ 5 mm (1.32) and tooth mobility (1.43). Hazard ratios of tooth loss and periodontal disease outcomes also increased per each additional positive MetS component
36	The number of positive MetS components was correlated with gingivitis in participants 12–18 years of age	OR: 1.92 (one MetS component)OR: 3.29 (three or more MetS components)
44	Individuals with longer durations of diabetes mellitus, hypertension and obesity, and/or a higher number of MetS components were more likely to have periodontal disease	OR: 3.82 (one MetS component)OR: 10.54 (more than two MetS components)
41	In a meta-analysis, those affected by MetS were nearly twice as likely to have periodontitis compared with those without MetS	OR: 1.7–2.1
38	Individuals with severe PPD (≥6 mm) and severe CAL (≥6 mm) and moderate PPD (4–5 mm) and moderate CAL (4-5 mm) had significantly higher risk for MetS	OR: 1.35 (severe PPD and CAL)OR: 1.25 (moderate PPD and CAL)
39	MetS was found to be significantly associated with periodontitis, in a dose–effect relationship	OR: 1.53 (three MetS components) OR: 2.20 (more than three MetS components)
45	A higher CPI code was associated with the presence of a higher number of MetS components	OR: 2.13 (three MetS components) OR: 2.34 (more than three MetS components)
46	Risk for more severe periodontal disease increased incrementally with the number of MetS components	OR: 1.8 (two MetS components) OR: 2.4 (three or four MetS components)
40	After adjusting for age, gender, education, toothbrushing, income, smoking and PI, the severity and extent of periodontal disease were significantly higher among patients with MetS compared with those without MetS	Compared with controls, those with MetS had significantly (P < 0.0005) higher GI, PPD, CAL, sites with CAL ≥ 3 mm and sites with PPD ≥ 3 mm
37	MetS has a prevalence of 18% in those with no/mild periodontitis but a prevalence of 37% in those with severe periodontitis (classified by clinical criteria of Page & Eke)

CAL, clinical attachment loss; CPI, Community Periodontal Index; GI, gingival index; IDF, International Diabetes Federation; NCEP ATP III, National Cholesterol Education Program's Adult Treatment Panel III; OR, odds ratio; PI, plaque index; PPD, probing pocket depth.