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      Presence of Metabolic Syndrome Components Is Associated with Tooth Loss in Middle-Aged Adults

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          Abstract

          Purpose

          In general, the prevalence of metabolic syndrome (MS) and tooth loss increases with age. We investigated the relationship between the presence of MS, its elements, and tooth loss in middle-aged Korean adults.

          Materials and Methods

          This study included Korean adults between 30 and 64 years of age who resided in the capital area of Seoul. From January to June 2014, individuals interested in participating in the oral health survey among those who visited the university hospital's cardiovascular center and provided informed consent were selected. Among 748 subjects who responded to the oral health questionnaires, 30 were excluded due to unclear responses; therefore, a total of 718 were included in the final analysis.

          Results

          The crude odds ratio (OR) of ≥one MS component affecting tooth loss was 1.45 [95% confidence interval (CI), 1.06–2.00]. After adjusting for sex, age, education, income level, occupation, smoking status, kidney disease, chronic obstructive pulmonary disease, and rheumatic disease, the adjusted OR was 1.47 (95% CI, 1.06–2.05), which was statistically significant ( p<0.05). The OR for tooth loss was higher in the presence of ≥one component of MS (50–64 years of age) in females.

          Conclusion

          This study suggests that female aged 50–64 years may have higher likelihood of tooth loss upon the presence of at least one MS component. Prevention against MS among female of older age could contribute to maintenance of remaining teeth. Further well-designed studies are needed.

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          Most cited references24

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          Tooth loss in 100 treated patients with periodontal disease. A long-term study.

          W T McFall (1982)
          A population of 100 patients with periodontal disease who had been treated and maintained for 15 years or longer was studied for tooth loss. The patients averaged 43.8 years of age and consisted of 59 females and 41 males. Patients were examined and their dental records were reviewed. On the basis of response to therapy and tooth loss, the patients were classified as Well-Maintained (77), Downhill (15), or Extreme Downhill (8). At the completion of initial treatment, 2,627 teeth were present. Of this number, during the maintenance period, 259 teeth (9.8%) were lost due to periodontal disease, while 40 teeth (1.5%) were lost due to other causes. Evaluation was made as to patterns of tooth loss, loss of questionable teeth, loss of teeth with furcations, surgical vs. nonsurgical therapy, and presence of fixed or removable prostheses. Considerable variation occurred between response groups. Periodontal disease appears to be bilaterally symmetrical and tooth loss response emulated this pattern with greatest loss of maxillary second molars and least loss of mandibular cuspids.
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            A cohort study on the association between periodontal disease and the development of metabolic syndrome.

            An association between periodontal disease and metabolic syndrome based on cross-sectional and case-control studies was recently reported, but their causal relationship has not been fully clarified. The objective of this cohort study is to investigate the association between periodontal disease and changes in metabolic-syndrome components to accumulate evidence of the causal relationship between the two conditions. The study subjects consisted of 1,023 adult employees (727 males and 296 females; mean age: 37.3 years) who underwent medical and dental checkups between 2002 and 2006 and in whom all metabolic-syndrome components were within the standard values in 2002. The association between the presence of periodontal pockets and the positive conversion of metabolic-syndrome components was investigated using multiple logistic-regression analysis, odds ratios (ORs), and 95% confidence intervals (CIs). The presence of periodontal pockets was associated with a positive conversion of one or more metabolic components during the 4-year observation period (OR: 1.6; 95% CI: 1.1 to 2.2). The ORs for a positive conversion of one component and two or more components were 1.4 (95% CI: 1.0 to 2.1) and 2.2 (95% CI: 1.1 to 4.1), respectively, and the difference was significant for two or more positive components. Of the metabolic-syndrome components, positive conversions of blood pressure and the blood-lipid index were significantly associated with the presence of periodontal pockets. The presence of periodontal pockets was associated with a positive conversion of metabolic-syndrome components, suggesting that preventing periodontal disease may prevent metabolic syndrome.
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              Associations of medical status and physical fitness with periodontal disease.

              To determine the possible associations of medical status and physical fitness with periodontal disease, a cross-sectional study was conducted. The subjects were 517 males and 113 females aged 23 to 83 years who participated in a multiphasic health test at the Aichi Prefectural Center of Health Care, Japan, from 1992 to 1997. Their periodontal status was assessed by means of the CPITN scoring system. To assess the strength of associations between the examined factors and the score, odds ratios were computed using ordinal logistic models. Conventional risk factors such as old age, smoking habits, and higher fasting plasma glucose and simplified debris index increased the risk of periodontal disease. Hypertension, hematuria, leucocytosis or thrombocytosis, positive C-reactive protein and higher serum alkaline phosphatase were positively associated with the score, whereas higher serum high-density lipoprotein cholesterol was related to a lower risk. Poor physical fitness affecting aerobic capacity, foot balance and reaction was associated with a higher CPITN score. These associations were independent of the conventional risk factors. Although these new potential risk factors should be further investigated for their causal relationship, our findings suggested a close relationship of oral health to medical status and physical fitness.
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                Author and article information

                Journal
                Yonsei Med J
                Yonsei Med. J
                YMJ
                Yonsei Medical Journal
                Yonsei University College of Medicine
                0513-5796
                1976-2437
                01 June 2019
                22 May 2019
                : 60
                : 6
                : 554-560
                Affiliations
                [1 ]Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea.
                [2 ]Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Korea.
                [3 ]Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
                [4 ]Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
                [5 ]Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan.
                [6 ]Department of Dental Hygiene, Ulsan College, Ulsan, Korea.
                Author notes
                Corresponding author: Youn-Hee Choi, DDS, MPH, PhD, Department of Preventive Dentistry, School of Dentistry, Institute for Translational Research in Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu 41940, Korea. Tel: 82-53-660-6875, Fax: 82-53-423-2947, cyh1001@ 123456knu.ac.kr
                Author information
                https://orcid.org/0000-0002-6127-3702
                https://orcid.org/0000-0001-5712-8097
                https://orcid.org/0000-0001-7867-1240
                https://orcid.org/0000-0002-8671-3153
                https://orcid.org/0000-0002-5158-147X
                https://orcid.org/0000-0001-8926-7091
                https://orcid.org/0000-0002-5416-5500
                Article
                10.3349/ymj.2019.60.6.554
                6536391
                31124339
                7cb3beb5-9e85-4238-98be-b449e294893c
                © Copyright: Yonsei University College of Medicine 2019

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 December 2018
                : 26 February 2019
                : 20 March 2019
                Funding
                Funded by: Korea Health Industry Development Institute, CrossRef https://doi.org/10.13039/501100003710;
                Award ID: HI13C0715
                Funded by: National Research Foundation of Korea, CrossRef https://doi.org/10.13039/501100003725;
                Award ID: NRF-2017S1A 3A2067165
                Categories
                Original Article
                Endocrinology and Metabolism

                Medicine
                metabolic syndrome,middle age,tooth loss
                Medicine
                metabolic syndrome, middle age, tooth loss

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