A Study of the Prevalence of Metabolic Syndrome and its association with stress among periodontal disease patients visiting Komfo Anokye Teaching Hospital

Background: Metabolic Syndrome (Met S) is a cluster of synergistically interacting cardiovascular risk factors consisting of insulin resistance, dyslipidaemia, obesity and hypertension. Studies indicate that Periodontal Disease (PD) shares similar risk factors and root cause with Met S. There are various links between periodontal disease and Met S which presupposes that patients with both clinical conditions may have a higher risk of the development of cardiovascular disease. Globally PD has been associated with Met S however, there is paucity of information on its prevalence among periodontal disease patients in Ghana. This research sought to find the prevalence of Met S in patients with PD and evaluate the relationship between the extent of PD and the various components of Met S. Materials and Method: This study was conducted at the Restorative Unit of the Department of Oral Health, Komfo Anokye Teaching Hospital (KATH) from March 2011 to February 2012. A total of 302 participants were recruited into the study consisting of 206 patients diagnosed with PD and 96 participants without PD as controls. The participants were selected after having undergone thorough Oral examination and met the criteria for inclusion. The participants then completed a questionnaire that captured their Socio-demographic, Oral Hygiene and PD modifying factors. This study assessed the Lipid Profile, Cardiac Enzymes, cortisol levels and Oxidative Stress among periodontal disease patients using Malondialdehyde, vitamin C and Uric Acid as oxidative stress markers. The haematological profile of each study participant was also evaluated. Results: Using the World Health Organization (WHO), National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) criteria for defining Met S, the prevalence of Met S among periodontal disease patients were 0.97%, 10.19% and 7.28% respectively. Prevalence of Met S increased with progression of the Periodontal disease with the highest in the advanced periodontitis study population. Hypertension emerged as iii the most predictive metabolic risk factor for periodontitis compared to controls from this study using the NCEP ATPIII (50% vs. 37.5%, p<0.05) while the WHO (42.72% vs.30.21%) and IDF (45.63% vs. 34.37%) criteria revealed abdominal obesity as the most predictive metabolic risk factor. Neutrophil and Monocyte count among persons with periodontal disease were significantly high in the study population. Cortisol levels were significantly high and increased with disease progression indicating some level of stress. Oxidative stress was associated with periodontal disease as confirmed by the significantly high levels of Malondialdehyde, Uric Acid and low levels of Vit C among the PD patients. Dyslipidaemia was also found to be associated with PD Conclusion: PD is associated with Met S and cardiovascular disease with Oxidative stress as a mutual link. Even though the prevalence of Met S is small among periodontal disease patients, there is the need for lifestyle changes and a good oral health to further reduce its incidence.

Source: KNUST