{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:08:18Z","timestamp":1785434898184,"version":"3.56.0"},"reference-count":64,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy, Timi\u0219oara, Romania"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Metabolic syndrome (MetS), defined by abdominal obesity, dysglycemia, dyslipidemia, hypertension, and insulin resistance, markedly increases the risk of type 2 diabetes mellitus and cardiovascular disease. Affecting an estimated 25\u201330% of the global adult population, MetS represents a major and growing public health challenge. A growing body of evidence supports a significant bidirectional relationship between MetS and oral health, particularly periodontitis. The present study aimed to synthesize current evidence on the pathophysiological mechanisms, epidemiological associations, interventional outcomes, and clinical implications of the bidirectional relationship between metabolic syndrome (MetS) and periodontitis. Methods: A narrative review following the SANRA framework was performed. PubMed, Scopus, and Web of Science were searched for articles published in January 2021\u2013March 2026 using MeSH and free-text terms including \u201cmetabolic syndrome\u201d, \u201cperiodontal disease\u201d, \u201cinsulin resistance\u201d, and \u201coral microbiota\u201d. Eligible studies included original research and systematic reviews in English with full-text availability; animal and in vitro studies were included if directly informative of mechanistic pathways. Results: A total of 64 references were selected for inclusion. Shared mechanisms include chronic systemic inflammation, insulin resistance, oxidative stress, adipokine imbalance, endothelial dysfunction, and oral\u2013gut microbiome dysbiosis. Cross-sectional and longitudinal studies show that MetS components are independently associated with higher prevalence and severity of periodontitis; meta-analyses report pooled odds ratios of 1.7\u20131.9 compared with metabolically healthy controls. Non-surgical periodontal therapy produces modest but significant reductions in glycated hemoglobin (HbA1c) and systemic inflammatory markers. Sodium\u2013glucose cotransporter-2 (SGLT2) inhibitors may alter oral microbiota composition and cause mucosal changes, while glucagon-like peptide-1 (GLP-1) receptor agonists may increase caries risk through gastrointestinal side effects and xerostomia; both drug classes warrant proactive dental monitoring. Conclusions: The bidirectional relationship between MetS and oral health supports integrated screening and interdisciplinary management. Routine periodontal assessment should be integrated into the metabolic risk management pathway, and dental professionals should screen patients with severe periodontitis for metabolic risk factors. The oral microbiome emerges as a promising target for future mechanistic research and therapeutic intervention. Recognition of oral health as an integral component of metabolic health may improve risk stratification, prevention, and long-term patient outcomes. Large-scale randomized controlled trials with standardized endpoints are needed to establish causal directionality and optimize combined therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm15145510","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:12:53Z","timestamp":1784023973000},"page":"5510","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic Syndrome and Periodontitis\u2014From Shared Mechanisms to Interdisciplinary Care: A Narrative Review of Clinical Evidence"],"prefix":"10.3390","volume":"15","author":[{"given":"Anna-Maria-Clara","family":"Gherbon","sequence":"first","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Faculty of Bioengineering of Animal Resources, University of Life Sciences \u201cKing Mihai I\u201d Timi\u0219oara, 300645 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-6859","authenticated-orcid":false,"given":"Mirela","family":"Frandes","sequence":"additional","affiliation":[{"name":"Department of Functional Sciences\u2014Medical Informatics and Biostatistics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center for Modeling Biological Systems and Data Analysis, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6281-6652","authenticated-orcid":false,"given":"Deiana","family":"Roman","sequence":"additional","affiliation":[{"name":"Department VII Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Railway Clinical Hospital, 300173 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Gherbon","sequence":"additional","affiliation":[{"name":"Department VII Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Diabetes, Nutrition, and Metabolic Diseases, \u201cPius Brinzeu\u201d Emergency Hospital, 300723 Timisoara, Romania"},{"name":"Center of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Maria","family":"Goguta","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Digital and Advanced Techniques for Endodontic, Restorative, and Prosthetic Treatment (TADERP) Research Center, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0792-9202","authenticated-orcid":false,"given":"Romulus","family":"Timar","sequence":"additional","affiliation":[{"name":"Department VII Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-5104","authenticated-orcid":false,"given":"Oana","family":"Albai","sequence":"additional","affiliation":[{"name":"Department VII Internal Medicine\u2014Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Diabetes, Nutrition, and Metabolic Diseases, \u201cPius Brinzeu\u201d Emergency Hospital, 300723 Timisoara, Romania"},{"name":"Center of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.1016\/j.numecd.2021.05.022","article-title":"Early identification of metabolic syndrome risk: A review of reviews and proposal for defining pre-metabolic syndrome status","volume":"31","author":"Gesteiro","year":"2021","journal-title":"Nutr. 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