The influence of metabolic syndrome on periodontal status

Metabolički sindrom (MetS) je skup metaboličkih poremećaja koji se nužno uvijek očituju zajedno te povećavaju rizik kardiovaskularnih oboljenja, dijabetesa tipa II, nealkoholne masne bolesti jetre i sindroma policističnih jajnika. Poremećaji koji čine ovo stanje jesu abdominalna pretilost, hipertenzija, aterogena dislipidemija, povišene vrijednosti glukoze u krvi i inzulinska rezistencija, a za postavljanje dijagnoze metaboličkog sindroma potrebno je potvrditi postojanje minimalno tri poremećaja. Upalna oboljenja parodontalnih tkiva dijelimo na gingivitise, gdje je upala ograničena samo na gingivu, i parodontitise gdje dolazi do zahvaćanja dubljih parodontnih struktura. Poveznica između parodontnih oboljenja i metaboličkog sindroma je blaga, sistemska upala. Kod metaboličkog sindroma uzrok je u visceralno smještenom masnom tkivu koje prekomjerno luči proupalne citokine i bioaktivne produkte dok su u parodontnim oboljenjima uzročnici mikroorganizmi. Proupalni citokini iz upalno promijenjenih parodontnih tkiva, cirkulirajući krvlju, mogu pogošati svaku od komponenti metaboličkog sindroma i vice versa. Veća incidencija, naglašeniji, rapidniji i progresivniji tijek obje upalne promjene parodonta u osoba oboljelih od metaboličkog sindroma nedvojbeno govore u prilog njihovoj povezanosti.Metabolic syndrome is a set of metabolic disorders that are necessarily always manifested together. They increase the risk of cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease and polycystic ovary syndrome. The disorders that make this condition are abdominal obesity, hypertension, atherogenic dyslipidemia, high blood glucoselevels and insulin resistance. In order to determine a diagnosis of metabolic syndrome it is necessary to confirm the existence of at least three disorders. Inflammatory diseases of periodontal tissues are divided into gingivitis, where inflammation is confined to the gingiva, and periodontitis where other, deeper periodontal structures are affected. The connection between periodontal disease and metabolic syndrome is a mild, systemic inflammation. In metabolic syndrome, the cause is in visceral fatty tissue that secreteexcessive pro-inflammatory cytokines and bioactive products, while periodontal diseases are caused by microorganisms. Pro-inflammatory cytokines from infected periodontal tissues circulating in blood can affect each of the components of metabolic syndrome and vice versa. Higher incidence, more pronounced, as well as faster and more progressive course of both inflammatory changes in periodontitis in people with metabolic syndrome certainly confirms the existence of a connection between them