NOW that the World Health Organization (WHO) has released on Dec. 9 of its 2019 Global Health Estimates, it is time to take a look at its implications on oral health.
The WHO Global Health Estimates list the Top 10 causes of death in the Philippines for both sexes and all ages in 2019.
Number one is ischaemic heart disease.
The other top diseases among Filipinos are lower respiratory infections, stroke, kidney diseases, hypertensive heart disease, chronic obstructive pulmonary disease, diabetes mellitus, tuberculosis, neonatal conditions, and interpersonal violence.
Except for lower respiratory infections, which is a communicable disease (and number two on the list), all the top causes of death in the Philippines are non-communicable diseases.
These are ischemic heart disease with 120.2 deaths per 100,000 population, stroke with 68.6 per 100,000 population, kidney diseases with 36.4 per 100,000 population, hypertensive heart disease with 31.9 per 100,000 population, chronic obstructive pulmonary disease with 30.1 per 100,000 population; and diabetes mellitus with 29.8 per 100,000 population.
Diabetes mellitus, commonly known as diabetes, is a disease that causes high blood sugar. Normally, insulin, a hormone, moves sugar from the blood into the cells to be stored or used for energy. When the body is unable to make enough insulin or cannot use the insulin it makes, diabetes results.
We highlight diabetes because periodontal or gum disease is known to be a significant risk factor of metabolic syndrome, a group of conditions increasing the risk for heart disease and diabetes.
In a new study, researchers from Tokyo Medical and Dental University discovered that infection with Porphyromonas gingivalis, the bacterium causing periodontal disease, causes skeletal muscle metabolic dysfunction, the precursor to metabolic syndrome.
Metabolic syndrome is a group of conditions including obesity, altered lipid metabolism, high blood pressure, high blood glucose levels, and systemic inflammation.
Periodontal bacteria have long been known to cause inflammation within the oral cavity. As a result, sustained infection with periodontal bacteria can lead to increases in body weight and lead to increased insulin resistance, a symptom of type 2 diabetes.
“Metabolic syndrome has become a widespread health problem in the developed world,” said Kazuki Watanabe, first author of the study. “The goal of our study was to investigate how periodontal bacterial infection might lead to metabolic alterations in skeletal muscle and thus to the development of the metabolic syndrome.”
The study showed that patients with metabolic syndrome were likely to have undergone infection with Porphyromonas gingivalis and thus have an immune response yielding antibodies against the germ.
“These are striking results that provide a mechanism underlying the relationship between infection with the periodontal bacterium Porphyromonas gingivalis and the development of the metabolic syndrome and metabolic dysfunction in skeletal muscle,” said Professor Sayaka Katagiri, the corresponding author of the study.
For their study, the researchers investigated antibody concentrations to Porphyromonas gingivalis in the blood of patients with metabolic syndrome and found a positive correlation between the antibodies and increased insulin resistance.
When the researchers fed mice a high-fat diet (a prerequisite to developing metabolic syndrome) with Porphyromonas gingivalis, the mice developed increased insulin resistance, and fat infiltration, and lower glucose uptake in the skeletal muscle compared with mice that did not receive the bacteria.
The researchers found that in mice fed with Porphyromonas gingivalis, the gut microbiome was significantly altered, which might decrease insulin sensitivity.
“These are striking results that provide a mechanism underlying the relationship between infection with the periodontal bacterium Porphyromonas gingivalis and the development of the metabolic syndrome and metabolic dysfunction in skeletal muscle,” said corresponding author Sayaka Katagiri, who is a professor at the university./PN
