{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:42:06Z","timestamp":1765539726349,"version":"3.48.0"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Loma Linda University School of Dentistry Student Research Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Metabolic syndrome (MetS) is a cluster of metabolic conditions that increase the risk of heart disease, stroke, and diabetes. This study aimed to test the hypothesis that MetS is associated with an increased risk of periodontitis in elderly individuals. Materials and Methods: The Loma Linda University (LLU) institutional review board approved the conduct of this study. Search queries scanned LLU School of Dentistry patient records to identify dentulous individuals \u2265 60 years, with a minimum of 15 teeth and a full mouth series of digital periapical radiographs. Out of 3534 records of individuals \u2265 60 years, random sampling selected 40 MetS cases and 40 healthy controls. Fifteen records were discarded due to inadequate radiographs. The concurrent presence of central obesity, type 2 diabetes, and hypertension was used to determine MetS status. Clinical periodontal measures were collected, and available radiographic records were used for alveolar bone measurements. Results: Probing depths \u2265 4 mm and bleeding on probing were significantly higher in the MetS group than the healthy group. Average alveolar bone levels, as well as sites with \u22654 mm bone loss, were also significantly higher in the MetS group than the healthy group. Multivariate analyses adjusting for demographics (age, gender, race), cigarette smoking, and plaque scores confirmed the adverse impact of MetS on periodontal measures. Conclusions: Elderly individuals with MetS have an increased risk of periodontal disease.<\/jats:p>","DOI":"10.3390\/medicina61122200","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:13:33Z","timestamp":1765538013000},"page":"2200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Comparison of Periodontal Health in Elderly Individuals with and Without Metabolic Syndrome: A Retrospective Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Jacqueline","family":"LeNoir","sequence":"first","affiliation":[{"name":"Private Practice, Albany, NY 12203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia","family":"Lenoir","sequence":"additional","affiliation":[{"name":"School of Dentistry, Loma Linda University, Loma Linda, CA 92350, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3226-453X","authenticated-orcid":false,"given":"Ahmed","family":"Khocht","sequence":"additional","affiliation":[{"name":"School of Dentistry, Loma Linda University, Loma Linda, CA 92350, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1002\/JPER.17-0721","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"89","author":"Papapanou","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.it.2013.09.001","article-title":"Immunomicrobial pathogenesis of periodontitis: Keystones, pathobionts, and host response","volume":"35","author":"Hajishengallis","year":"2014","journal-title":"Trends Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/prd.12002","article-title":"Inflammatory and immune pathways in the pathogenesis of periodontal disease","volume":"64","author":"Cekici","year":"2014","journal-title":"Periodontology 2000"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1177\/0022034512457373","article-title":"Prevalence of periodontitis in adults in the United States: 2009 and 2010","volume":"91","author":"Eke","year":"2012","journal-title":"J. Dent. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/prd.12145","article-title":"Periodontitis prevalence in adults \u2265 65 years of age, in the USA","volume":"72","author":"Eke","year":"2016","journal-title":"Periodontology 2000"},{"key":"ref_6","first-page":"e13","article-title":"Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific issues related to definition","volume":"24","author":"Grundy","year":"2004","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kosho, M.X.F., Verhelst, A.R.E., Teeuw, W.J., van Bruchem, S., Nazmi, K., Gerdes, V.E.A., and Loos, B.G. (2024). The Prevalence of Metabolic Syndrome and Undiagnosed Diabetes in Periodontitis Patients and Non-Periodontitis Controls in a Dental School. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247512"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1177\/0022034514561658","article-title":"Metabolic syndrome exacerbates inflammation and bone loss in periodontitis","volume":"94","author":"Li","year":"2015","journal-title":"J. Dent. Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tam, J., Hoffmann, T., Fischer, S., Bornstein, S., Grassler, J., and Noack, B. (2018). Obesity alters composition and diversity of the oral microbiota in patients with type 2 diabetes mellitus independently of glycemic control. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204724"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/prd.12326","article-title":"The association of periodontal diseases with metabolic syndrome and obesity","volume":"83","author":"Jepsen","year":"2020","journal-title":"Periodontology 2000"},{"key":"ref_11","first-page":"1","article-title":"The Association of Periodontitis with Risk of Prevalent and Incident Metabolic Syndrome","volume":"53","author":"Kinnunen","year":"2025","journal-title":"J. Clin. Periodontol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.2147\/JMDH.S499516","article-title":"The Association Between Periodontitis and the Prevalence and Prognosis of Metabolic Syndrome","volume":"18","author":"Li","year":"2025","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/jcpe.13881","article-title":"Periodontitis and the incidence of metabolic syndrome: An 8-year longitudinal study of an adult Japanese cohort","volume":"51","author":"Saito","year":"2024","journal-title":"J. Clin. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E24","DOI":"10.5888\/pcd14.160287","article-title":"Metabolic Syndrome Prevalence by Race\/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988\u20132012","volume":"14","author":"Moore","year":"2017","journal-title":"Prev. Chronic Dis."},{"key":"ref_15","unstructured":"(2025, October 20). Bureau USC. Older Americans Month: May 2017, Available online: www.census.gov\/newsroom\/facts-for-features\/2017\/cb17-ff08.html."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1080\/00223891.2012.660293","article-title":"Further investigation of the validity and reliability of the photographic figure rating scale for body image assessment","volume":"94","author":"Swami","year":"2012","journal-title":"J. Pers. Assess."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1080\/00031305.1981.10479327","article-title":"Rank Transformations as a Bridge Between Parametric and Nonparametric Statistics","volume":"35","author":"Conover","year":"1981","journal-title":"Am. Stat."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kassi, E., Pervanidou, P., Kaltsas, G., and Chrousos, G. (2011). Metabolic syndrome: Definitions and controversies. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-48"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e158451","DOI":"10.1172\/JCI158451","article-title":"Metabolic changes in aging humans: Current evidence and therapeutic strategies","volume":"132","author":"Palmer","year":"2022","journal-title":"J. Clin. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S422","DOI":"10.1513\/AnnalsATS.201602-095AW","article-title":"Aging of the Immune System. Mechanisms and Therapeutic Targets","volume":"13","author":"Weyand","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/BF03324802","article-title":"Association of periodontitis and metabolic syndrome in the Baltimore Longitudinal Study of Aging","volume":"22","author":"Nesbitt","year":"2010","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1177\/0022034516641053","article-title":"Metabolic Syndrome and Periodontal Disease Progression in Men","volume":"95","author":"Kaye","year":"2016","journal-title":"J. Dent. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/idh.12350","article-title":"The association between periodontal disease severity and metabolic syndrome in Vietnamese patients","volume":"16","author":"Pham","year":"2018","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/jcpe.13154","article-title":"Long-term metabolic syndrome is associated with periodontal pockets and alveolar bone loss","volume":"46","author":"Tegelberg","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.25122\/jml-2020-0073","article-title":"Prevalence and Intensity of Periodontal Disease in Individuals with Metabolic Syndrome","volume":"13","author":"Hlushchenko","year":"2020","journal-title":"J. Med. Life"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6184","DOI":"10.3390\/ijms15046184","article-title":"Obesity and its metabolic complications: The role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease","volume":"15","author":"Jung","year":"2014","journal-title":"Int. J. Mol. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Longo, M., Zatterale, F., Naderi, J., Parrillo, L., Formisano, P., Raciti, G.A., Beguinot, F., and Miele, C. (2019). Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20092358"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/s41415-019-0611-1","article-title":"Review of obesity and periodontitis: An epidemiological view","volume":"227","author":"Arboleda","year":"2019","journal-title":"Br. Dent. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1007\/s00784-016-1793-4","article-title":"Efficacy of non-surgical periodontal therapy in the management of chronic periodontitis among obese and non-obese patients: A systematic review and meta-analysis","volume":"20","author":"Akram","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/154405910708600503","article-title":"Obesity, inflammation, and periodontal disease","volume":"86","author":"Pischon","year":"2007","journal-title":"J. Dent. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1902\/jop.2015.150424","article-title":"Porphyromonas gingivalis and Epstein-Barr Virus Are Associated With Increased Levels of Visfatin in Gingival Crevicular Fluid","volume":"87","author":"Ozcan","year":"2016","journal-title":"J. Periodontol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1111\/jcpe.13860","article-title":"Metabolomic profiles of obesity and subgingival microbiome in periodontally healthy individuals: A cross-sectional study","volume":"50","author":"Khocht","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wu, C.Z., Yuan, Y.H., Liu, H.H., Li, S.S., Zhang, B.W., Chen, W., An, Z.-J., Chen, S.-Y., Wu, Y.-Z., and Han, B. (2020). Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01180-w"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1016\/j.dsx.2019.03.023","article-title":"The relationship of diabetes, periodontitis and cardiovascular disease","volume":"13","author":"Khumaedi","year":"2019","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1902\/jop.2011.110207","article-title":"Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: A literature review","volume":"83","author":"Javed","year":"2012","journal-title":"J. Periodontol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1902\/jop.2013.134005","article-title":"A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes","volume":"84","author":"Taylor","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J. Am. Coll Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/HJH.0b013e32834d249a","article-title":"Plasma levels of matrix metalloproteinases and their inhibitors in hypertension: A systematic review and meta-analysis","volume":"30","author":"Marchesi","year":"2012","journal-title":"J. Hypertens."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.maturitas.2014.04.012","article-title":"Impact of inflammation on vascular disease in hypertension","volume":"78","author":"Virdis","year":"2014","journal-title":"Maturitas"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"768237","DOI":"10.1155\/2014\/768237","article-title":"Association between hypertension and periodontitis: Possible mechanisms","volume":"2014","author":"Leong","year":"2014","journal-title":"Sci. World J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.atherosclerosis.2011.04.030","article-title":"Periodontitis and blood pressure: The concept of dental hypertension","volume":"219","author":"Tsioufis","year":"2011","journal-title":"Atherosclerosis"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1902\/jop.2010.090705","article-title":"Hypertension may affect tooth-supporting alveolar bone quality: A study in rats","volume":"81","author":"Bastos","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_43","first-page":"269","article-title":"Gingival Fluid Inflammatory Biomarkers and Hypertension in African Americans","volume":"2","author":"Khocht","year":"2017","journal-title":"JDR Clin. Trans. Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/12\/2200\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:38:56Z","timestamp":1765539536000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/12\/2200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":43,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["medicina61122200"],"URL":"https:\/\/doi.org\/10.3390\/medicina61122200","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}