Abstract
BACKGROUND: Periodontitis is one of the most common diseases associated with the oral cavity. Previous studies have suggested that there is an association between periodontitis and metabolic dysfunction. Recently, the triglyceride glucose (TyG) index, high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index have been identified as useful markers for assessing insulin resistance. OBJECTIVE: This study aimed to evaluate the relationship between periodontitis and non-insulin-based insulin resistance (IR) indices and compare the predictive values of these indices in the Korean population. DESIGN: This is a cross-sectional study. METHODS: A total of 13,584 participants were included in the 2013-2015 Korean National Health and Nutrition Examination Survey data. A community periodontal index score⩾3 was used to define periodontitis. Participants were divided into quartiles according to each index. Odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of periodontitis and the TyG index, TG/HDL-C ratio, and METS-IR index quartiles were calculated using multiple logistic regression analysis. We estimated the areas under the receiver operating characteristic curves (AUCs) of the indices to compare the predictive values of the three indices. RESULTS: Compared with quartile 1, the fourth quartile ORs (95% CIs) for periodontitis were 1.23 (1.01-1.49) for the TyG index, 1.23 (1.02-1.48) for the TG/HDL-C ratio, and 1.53 (1.25-1.88) for the METS-IR index after adjustment for confounders. The AUC (95% CIs) was 0.608 (0.598-0.618) for the TyG index, 0.600 (0.590-0.610) for the TG/HDL-C ratio, and 0.617 (0.608-0.627) for the METS-IR index to identify periodontitis. The predictive power of METS-IR was significantly higher than that of the TyG index and TG/HDL-C. CONCLUSION: Higher TG/HDL-C ratio, TyG, and METS-IR indices are associated with a higher prevalence of periodontitis. The METS-IR index is a more powerful predictor of periodontitis prevalence than the TyG index and TG/HDL-C ratio.