Childhood Oral Infections Associate with Adulthood Metabolic Syndrome: A Longitudinal Cohort Study

Abstract

Chronic oral infection/inflammation is cross-sectionally associated with metabolic syndrome (MetS) in adults, but there are few longitudinal studies and studies on childhood oral infections and adult MetS risk. We investigated whether childhood clinical parameters indicative of oral infection/inflammation were associated with adulthood MetS and its components. A total of 755 children aged 6, 9, and 12 y underwent a clinical oral examination in 1980 as part of the Cardiovascular Risk in Young Finns Study. Oral health measures included bleeding on probing (BOP), periodontal probing pocket depth, caries, fillings, and visible plaque. Metabolic parameters were determined at baseline and during follow-up. MetS was diagnosed (n = 588, 77.9%) in the adulthood at 21 y (in 2001), 27 y (in 2007), and 31 y (in 2011) after the oral assessment, when the participants were 27 to 43 y old. Regression analyses were adjusted for childhood age, sex, body mass index, and family income, as well as adulthood smoking and education level. In adulthood, MetS was diagnosed in 11.9% (2001), 18.7% (2007), and 20.7% (2011) of participants at the 3 follow-ups. Childhood caries and fillings were associated with increased risk of adult MetS (risk ratio [95% CI], 1.25 [0.90 to 2.45] and 1.27 [1.02 to 1.99]) and with increased systolic blood pressure (1.78 [1.01 to 4.26] and 2.48 [1.11 to 4.12]) and waist circumference (2.25 [1.02 to 4.99] and 1.56 [1.01 to 3.25]), whereas BOP and visible plaque were associated with plasma glucose (1.97 [1.08 to 3.60] and 1.88 [1.00 to 3.53]). Severity of BOP (P = 0.015) and caries (P = 0.005) and teeth with plaque (P = 0.027) were associated with number of MetS components. No such trends were seen with probing pocket depth. Childhood oral infection/inflammation was associated with adverse metabolic parameters and MetS in adulthood.

Keywords: caries; gingivitis; inflammation; pediatric dentistry; periodontal disease(s); periodontitis.

Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.

Presence of childhood oral infection/inflammation and adulthood metabolic syndrome (MetS). A total of 755 children had a clinical oral examination in 1980, and 4 signs of oral infections were registered: caries, fillings, bleeding on probing (BOP), and increased probing pocket depth (PPD). The presence of these symptoms is shown among participants diagnosed in adulthood with MetS (A) or one its components: high systolic blood pressure (B), large waist circumference (C), and high glucose (D). Significant P values are shown for differences between the groups after adjusting for age and sex. The whole data for all years and all MetS components are presented in Appendix Table 3.

Figure 2.

Number of positive metabolic syndrome (MetS) components in adulthood according to the presence of oral infection/inflammation in childhood. The mean number of positive MetS components (95% CI) is shown for adulthood in years 2001 (n = 461), 2007 (n = 465), and 2011 (n = 426) as well as for all years combined (n = 588). Participants were divided into 3 groups according to the presence of caries and gingival inflammation: 1) no caries or fillings, 2) only untreated caries present, and 3) only treated caries present and 1) no bleeding on probing (BOP), 2) BOP <30%, and 3) BOP ≥30%. P values are shown for weighted linear trend in analysis of variance.