Association between components of metabolic syndrome and periodontitis: a systematic review and meta-analysis

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 (OR_adj from 1.27 to 1.90; PR_ajd = 1.19; RR_adj 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.

Keywords: Hyperglycemia; Hypertension; Metabolic syndrome; Obesity; Periodontal diseases; Periodontitis.