The Prevalence of Metabolic Syndrome and Undiagnosed Diabetes in Periodontitis Patients and Non-Periodontitis Controls in a Dental School

<b>Background/Objectives</b>: Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are major global health concerns, and they often go undetected. Periodontitis shares risk factors and is associated with both conditions. Assessing MetS risk factors among dental patients, especially those with periodontitis, may contribute to early detection and prompt treatment. However, current information about MetS prevalence rates in dental settings is limited. Therefore, our aim was to investigate the prevalence of MetS among patients with generalized periodontitis stage III/IV (GenPD), localized periodontitis stage III/IV (LocPD), and non-periodontitis controls. We also investigated the prevalence of undiagnosed T2DM in the same population. Moreover, we performed a pilot study to evaluate the possibility of measuring fructosamine levels in oral rinse samples, as an alternative to HbA1c, to screen for hyperglycemia. <b>Methods</b>: Periodontitis patients and non-periodontitis controls were recruited from a dental school, all aged ≥ 40 years. MetS prevalence was determined according to four different MetS definitions. T2DM prevalence was based on elevated HbA1c levels (HbA1c ≥ 7.0%). Biochemical analysis from blood was carried out by finger stick sampling. A subset of participants was asked to provide an oral rinse sample for the measurement of fructosamine, which was correlated to HbA1c from blood. <b>Results</b>: A total of 105 patients with periodontitis (GenPD stage III/IV: n = 44, LocPD stage III/IV: n = 61) and 88 non-periodontitis controls, with a mean age of 54.4 years, were included. The prevalence of MetS, according to four different MetS definitions, was 68.2-81.8% in GenPD patients, 42.6-62.3% in LocPD patients, and 52.3-69.3% in controls. The prevalence of T2DM, as evidenced by elevated HbA1c, was 20.5% in GenPD patients, 18.3% in LocPD patients, and 10.2% in controls (<i>p</i> = 0.094). A substantial number of subjects were not aware that they were being suspected to have T2DM, i.e., 13.6% in GenPD patients, 8.2% in LocPD patients, and 8.0% in controls (<i>p</i> = 0.335). In a subset of participants (n = 48), we found no significant correlation between HbA1c and oral fructosamine (r= 0.24, <i>p</i> = 0.103). <b>Conclusions</b>: The overall results showed a relatively high prevalence of patients with MetS and/or elevated HbA1c among periodontitis patients and controls in the dental school. Of those with suspected T2DM, a substantial number were not aware of having T2DM. Oral health care professionals could therefore contribute to early detection for T2DM and/or create awareness in patients at risk for a disease related to MetS. To date, initial results on the use of oral fructosamine as an alternative for HbA1c cast doubt, and further research is needed.