Abstract
OBJECTIVE: Periodontitis and metabolic syndrome (MetS) are both linked to inflammation, but their association remains unclear. This study aimed to explore the association between periodontitis and MetS prevalence and evaluate its impact on the prognosis of all-cause and cardiovascular mortality in MetS. METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database. Logistic regression analysis was used to investigate the association between periodontitis and the prevalence of MetS, while Cox regression analysis was applied to assess the association between periodontal status and the poor prognosis in individuals with MetS. Furthermore, restricted cubic spline (RCS) analysis was performed to evaluate the linear and nonlinear associations between periodontal parameters, including attachment loss (AL) and probing depth (PD), and the prevalence and mortality of MetS. RESULTS: A total of 9,270 individuals were included in the analysis. Individuals with periodontitis had a higher prevalence of MetS compared to those without periodontitis (OR=1.24, 95% CI: 1.08-1.43). Cox regression analysis revealed that periodontitis was associated with an increased risk of all-cause mortality (HR=2.03, 95% CI:1.40-2.92) and cardiovascular mortality (HR=2.32, 95% CI:1.05-5.10) among individuals with MetS. Furthermore, the RCS analysis demonstrated that AL had a nonlinear association with the risk of prevalence, all-cause mortality and cardiovascular mortality in MetS (P for nonlinearity < 0.05). However, PD was linearly associated with the increased risks of these outcomes (P overall < 0.05). CONCLUSION: Periodontitis is associated with an increased risk of MetS, as well as higher risks of all-cause and cardiovascular mortality.