Integrative Study for the Impacts of Periodontal Disease on Metabolic Syndrome

牙周病被认为是生活方式疾病之一。最近的研究表明，一些全身性疾病，包括糖尿病，肥胖和血脂异常，与牙周炎有关。代谢综合征是一组多种危险因素，如致动脉粥样硬化性血脂异常、血糖升高和血压升高，以及内脏肥胖。许多研究者认为这种综合征是动脉粥样硬化性心血管疾病的多方面危险因素。代谢综合征和牙周病都涉及先天免疫和炎症的激活，但目前关于代谢综合征和牙周病之间的直接关系的研究很少，本研究旨在探讨牙周病与代谢综合征的关系。我们对爱知学院大学牙科医院的患者进行了筛查。我们测量了代谢综合征的标准（腰围、血压、空腹血脂、空腹血糖水平）以及口腔检查结果和牙周炎评估。为了评价动脉粥样硬化，我们测量了脉搏波速度、踝臂指数和趾臂指数。代谢综合征组的残牙数明显减少，探牙出血数明显增加。代谢综合征组中牙周袋大于4mm或附着丧失的牙周炎患者明显增多。此外，牙周炎的严重程度与代谢综合征因子的数量有关。这些结果表明代谢综合征和牙周炎之间的双向关系。前瞻性研究目前正在我院进行。

Periodontal disease is considered as one of the life style diseases. Recent studies have suggested that several systemic conditions, including diabetes, obesity, and dyslipidemia, are related to periodontitis. Metabolic syndrome is a constellation of multiple risk factors, such as atherogenic dyslipidemia, elevated plasma glucose and elevated blood pressure, in addition to visceral obesity. Many investigators consider this syndrome to be a multidimensional risk factor for atherosclerotic cardiovascular disease. Both metabolic syndrome and periodontal disease are involved in activation of innate immunity and inflammation, but there is little information available concerning the direct association between metabolic syndrome and periodontal disease.The present study was conducted to evaluate the relationships between periodontal disease and metabolic syndrome. We have screened patients attending Aichi Gakuin University Dental Hospital. We have measured criteria of metabolic syndrome (waist circumference, blood pressure, fasting serum lipids, fasting plasma glucose level) as well as findings of oral cavity and assessments of periodontitis. For the evaluation of atherosclerosis, we have measured pulse wave velocity, ankle-brachial index and toe-brachial index. The group who have metabolic syndrome significantly decreased number of residual teeth and increased number of bleeding on probing teeth. Periodontitis who have above 4mm periodontal pocket or attachment loss were significantly increased in the metabolic syndrome group. Furthermore, the severity of periodontitis was associated the number of holding metabolic syndrome factors. These results suggest the bidirectional relationship between metabolic syndrome and periodontitis. Prospective study is now under investigation in our hospital.