AS287 - Metabolic syndrome, lifestyle factors and risk of periodontitis in older women

Investigator Names and Contact Information

Michael Lamonte

Introduction/Intent

The goal of this proposal is to use existing prospective data to examine associations of metabolic syndrome (Metsyn) and lifestyle factors (physical activity and body composition) with the prevalence and progression of periodontal disease in a cohort of postmenopausal women. A small amount of published data suggests that the presence of Metsyn is associated with a higher prevalence periodontal disease. The role of Metsyn in the development and progression of periodontal disease is unclear. The cornerstone therapy for managing Metsyn and risk of its primary clinical sequellea (cardiovascular disease and diabetes) is increased physical activity and weight loss. Both physical inactivity and obesity are associated with prevalent periodontal disease. Whether higher physical activity and lower body fat levels attenuate the association between Metsyn and periodontal disease is unknown. To firmly establish that Metsyn is a risk factor for periodontal disease and to examine the role of lifestyle factors in modifying risk, longitudinal studies are needed in which the temporal sequence of exposure and outcome assessment is suitable for etiological hypothesis testing.

We propose a prospective study in 670 postmenopausal women who completed comprehensive dental examinations at baseline and at a 5-year reexamination. The baseline assessment included a fasting blood sample, detailed lifestyle and health histories, and measures of resting blood pressure, anthropometry, and body composition (DXA). We propose to measure in the stored baseline blood samples the phenotypes required to define Metsyn and selected biomarkers related to insulin resistance and inflammation that may influence the Metsyn-periodontal disease association as an effect modifier or pathway intermediate. Our primary definition of Metsyn will be based on criteria from the National Cholesterol Education Program. We will characterize participants according to their body weight, body mass index (BMI), body composition (fat-free mass, fat mass, percent body fat), and fat distribution (waist and hip circumferences). Physical activity habits will be characterized using responses to a detailed interview-administered questionnaire. Our primary definition of prevalent and progressive periodontal disease will be based on alveolar crestal height. The following aims will focus the proposed work:

Primary Aim 1: To determine if at baseline the prevalence of periodontal disease is higher in women with than without Metsyn, and the extent to which physical activity and body composition modify this association.

Primary Aim 2: To determine if the progression of periodontal disease is different between women with and without Metsyn, and the extent to which baseline physical activity and body composition modify these risks.

Primary Aim 3: For each of the above Aims (1-2), we will conduct separate analyses to determine the extent to which baseline differences in insulin sensitivity (HOMA) and inflammatory biomarkers (e.g., CRP, IL6) explain associations between Metsyn and periodontal disease, and/or explain the affect of physical activity and body composition on the association between Metsyn and periodontal disease.

Results/Findings

For a complete, up-to-date list of WHI papers related to this ancillary study, please use the searchable Papers section of this website.