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Background/Objectives: 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. Methods: 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. Results: 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 (p = 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 (p = 0.335). In a subset of participants (n = 48), we found no significant correlation between HbA1c and oral fructosamine (r= 0.24, p = 0.103). Conclusions: 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. [ABSTRACT FROM AUTHOR]

Summary: Weight regain or inadequate weight loss following Roux‐en‐Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux‐en‐Y gastric bypass through a systematic review and meta‐analysis. We performed a literature search (in PubMed and Embase) on revisional interventions in collaboration with a medical information specialist. Measured outcomes included body mass index at intervention, total weight loss during follow‐up, and complications. Random effects models were used to determine pooled effect size and corresponding 95% confidence intervals. Thirty‐nine studies were included: four studies reported on argon plasma coagulation, four studies on transoral outlet reduction, nine studies on transoral outlet reduction + argon plasma coagulation, four studies on pouch/gastrojejunal anastomosis revision, five on laparoscopic gastric banding, two studies on laparoscopic gastric banding + pouch resizing, 10 on distalization‐RYGB, and one on duodenal switch. All techniques resulted in short‐term clinically relevant weight loss. Endoscopic procedures had a short follow‐up and resulted in modest and temporary weight loss. Surgical revision techniques were successful for weight loss in longer term follow‐up, at the expense of high complication rates. [ABSTRACT FROM AUTHOR]

Objectives: Although many studies have reported a higher risk of atherosclerotic cardiovascular diseases (ACVD) in people with periodontitis (PD), this has been tested in a few large‐scale population‐based studies with a longitudinal design. The aim of this study was to investigate whether people with PD status have an increased risk of a nonfatal ACVD event compared to people without PD status. Methods: A cohort of 1.2 million participants from a healthcare insurance claims database was studied longitudinally for a period of 8 years. PD status was derived from PD‐related insurance claims and ACVD status from ACVD‐related insurance claims. Person‐time at risk (PTAR) was calculated from the start of follow‐up (01 January 2007) for participants with and without PD status until ACVD or event‐free censoring (31 December 2014). Time‐dependent Cox proportional hazard models were used to calculate the hazard ratio (HR) and to adjust for shared risk factors (age, sex, socioeconomic position and diabetes mellitus). Results: The prevalence of PD was 20.1%, and the cumulative incidence of nonfatal ACVD events was 7.5%. The univariable and multivariable analyses revealed a limited risk of ACVD for participants with PD status (HR: 1.12; 95% CI 1.10–1.14, HR: 1.06; 95% CI 1.04–1.08, respectively). A subgroup analysis of participants ≤35 and > 35 years of age showed that those ≤35 years of age with PD status had a higher ACVD risk (univariable HR: 1.20; 95% CI 1.05–1.37, multivariable HR: 1.21; 95% CI 1.05–1.39). ACVD risk was not increased in participants >35 years of age with PD status (univariable HR: 0.92; 95% CI 0.91–0.94, multivariable HR: 0.96; 95% CI 0.94–0.98). Conclusions: This study based on a healthcare insurance cohort shows that PD can hardly be regarded as a risk factor for nonfatal ACVD. The increased risk is of minor size, and therefore, the proposed role of PD in the development of ACVD events should be reconsidered. Possibly PD plays a role as a risk factor in younger people due to overlapping genetic risk factors of ACVD and a more aggressive course of PD. [ABSTRACT FROM AUTHOR]