Associazione fra sindrome metabolica e parodontite: ruolo dei singoli fattori di rischio e delle loro diverse combinazioni

Background. Metabolic Syndrome (MetS) is characterized by the presence of at least three of the following factors, including hyperglycemia, hypertension, hypertriglyceridemia, high waist circumference, and low HDL cholesterol values. In this clinical condition, the patient is at high risk for cardiovascular events. The MetS is associated with periodontitis through inflammatory mechanisms, but the impact of the individual MetS factors on this association remains undetermined. Materials and methods. The third National Health and Nutrition Examination Survey (NHANES III) was used to test whether individuals aged > 18 years undergoing periodontal examination (population) exposed to at least one MetS factor (exposure), matched with Propensity Score Matching for gender, age, race, and socioeconomic status to non-exposed individuals to any MetS factor (controls), were more likely to have periodontal disease (periodontitis and gingival bleeding, alone or in combination) (outcome) than their counterpart. Another aim was to explore the relationship between MetS factor combinations and periodontal disease. Univariate or multimodal logistic regression models explored the association between exposure and outcome. Machine learning was used to define the ability to predict periodontal health, starting from the MetS factors. Results. Two groups composed of 1699 individuals each were analyzed. They were homogeneous for the major clinical-demographic confounders. The exposed group showed a higher risk of periodontitis (+ 26%) and gingival bleeding (+ 75%) than the unexposed. The association between the number of components of MetS grew linearly with gingival bleeding but not with periodontitis. The C reactive protein increased linearly significantly with the increase of the inflamed periodontal surface (PISA). The combination of hyperglycemia and arterial hypertension doubled the risk of periodontitis. The combination of all MetS factors tripled the risk of gingival bleeding. Conclusion. MetS and periodontitis or gingival bleeding are associated conditions. Close monitoring by the clinician should be implemented in these high-risk patients. Further studies are needed to validate these findings and expand their clinical significance.