Background Chronic inflammatory diseases such as Rheumatoid Arthritis (RA) and periodontal disease (PD) havebeen associated with accelerated cardiovascular disease and Metabolic Syndrome (MS) is also strongly associatedwith this condition. No previous study, to our knowledge, has investigated if more severe PD influences the emergence of MS in RA.
Objectives To demonstrate that a more severe PD is independently associated with MS in RA population.
Methods A cross sectional study. All subjects met the ACR criteria, had no other autoimmune disease. We excluded patients with less than 4 teeth, serious or local ongoing infections, oral cancer or precancerous lesion, hospitalized, pregnant, local antibiotics (previous 3 months) or drugs associated with gingival hyperplasia. A personal interview, physical examination, auxiliary tests and medical chart review were performed. Diagnosis and severity of PD were defined according to the American Academy of Periodontology criteria. Severity was categorized on the basis of the amount of clinical attachment loss as mild, moderate or severe. Alldental assessments were interpreted by three odolontologist blind to clinical patient condition. MS was defined according to International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.2009. Statistical analysis: First an univariated x2 analysis was performed to evaluatethe association between MS and PD severity, then a logistic binary regression model adjusted to age, tobacco, gender, rheumatoid factor (RF), disease duration (DD), socioeconomic level (Graffar scale), disease activity (DAS28CRP), functional status (MDHAQ), body fat distribution by DXA(trunk-to-leg fat ratio), percentage of body fat by DXA, body mass index(BMI) and current dose of glucocorticoids was done to assess the persistence of the association. Statistical package SPSSv16.0 was used.
Results 165 patients were evaluated, all mestizos, 90.3% were women, average (SD) age was 58.96 (12.51) years, DD: 15.47(11.43) years, socioeconomic status was more frequently medium, (middle Class: 36.2%), 89.7% were RF(+), and the DAS28CRP was 4.06 (1.19); 17% were current or past smokers. Mean BMI was 27.91(4.89)kg/m2. Current dose of prednisone: 4.92 (3.43) mg/d;124 patients (75.2%) had PD, mostly moderate (43.6%). A MS was identified in 37.6% patients. In the adjusted model a higher PD severity was independently associated with MS (OR: 2.92; p=0.006).
Conclusions In our RA patients, more severe PD correlates with MS independently of other known associated factors. Prospective studies to explore cardiovascular risk in RA patients with PD are necessary to establish the impact of this condition.
Disclosure of Interest None Declared
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