The association between metabolic syndrome and periodontitis in Spain: Results from the WORALTH (Workers’ ORAL healTH) Study

Eduardo Montero, Ana Molina, Miguel Carasol, Ana Fernández-Meseguer, Eva Calvo-Bonacho, María Teresa García-Margallo, Mariano Sanz, David Herrera
J Clin Periodontol . 2021 Jan;48(1):37-49. doi: 10.1111/jcpe.13391. Epub 2020 Nov 17.


Introduction: Evidence of an association between periodontitis and MetS (metabolic syndrome) remains controversial. The objective of this study is to evaluate the association between periodontitis and MetS in a cross-sectional population survey.

Material and Methods: WORALTH (Workers’ ORAL healTH) Study is a cross-sectional survey, conducted on a representative sample of the Spanish employed population, including 5154 participants. An oral examination following the World Health Organization (WHO) criteria evaluated the periodontal status using the Community Periodontal Index (CPI) and Clinical Attachment Levels (CAL). Logistic regression analysis with adjustment for potential confounders was used to evaluate the association between periodontitis and MetS, and its individual components.

Results: Participants presenting a CPI = 4 were more likely to have MetS than subjects with CPI < 4 [odds ratio, OR = 1.41; 95% confidence interval (CI) 1.10–1.81; p < 0.001].

High blood pressure was the component with stronger association with periodontal status (OR = 1.94 for CAL ≥6 mm; 95% CI 1.49–2.53; p < 0.001). After stratifying for sex, the association was higher in women (OR = 2.20 for CPI = 4; 95% CI 1.31–3.62; p < 0.001). Non-metabolically healthy subjects, obese or not, presented a worse periodontal condition.

Conclusion: Severe periodontitis (CPI = 4) was associated with MetS in a representative sample of the Spanish employed population. This association seems to be independent of body mass index and other potential confounders.


dental health surveys, high blood pressure, impaired glucose regulation, metabolic syndrome, obesity, periodontitis

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