Radiographic Assessment of Alveolar Bone Levels in Elderly Individuals With Metabolic Syndrome

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 alveolar bone loss in elderly individuals.
Methods: Loma Linda University (LLU) institutional review board approved conduct of this study. Search queries scanned LLU School of Dentistry patient records (2016-2020) to identify dentulous individuals ≥60 yrs., with a minimum of 15 teeth and a full mouth series of digital periapical radiographs. The concurrent presence of central obesity, type 2 diabetes and hypertension was used to determine MetS. Alveolar bone level (BL) on interproximal sites of all teeth was measured from periapical radiographs. The distance from the cementoenamel junction (CEJ) to the most coronal point where the periodontal ligament space remained at normal width was measured in millimeters. Examiners were blinded to MetS status. Power analysis indicated 29 records per group are needed at 80% power.
Results: Out of 2369 records of individuals ≥60 yrs., random sampling selected 40 MetS cases and 40 healthy controls. Fifteen records were discarded due to inadequate radiographs. The significance of the difference in BL between MetS cases and controls was determined using the Wilcoxon rank-sum test. MetS cases showed higher average bone loss (p=0.03) and greater percent of sites with ≥4mm bone loss (p=0.02) than controls. Multivariate regression analyses adjusting for age, race, sex, cigarette smoking, and plaque score confirmed an independent association between MetS and BL.
Conclusions: Elderly individuals with MetS have an increased risk for alveolar bone loss.