Polycystic ovary syndrome and periodontal disease: an until-now undiscovered connection influenced by metabolic parameters

Aims This study aimed to determine whether women with polycystic ovary syndrome (PCOS) exhibit a higher prevalence of periodontal diseases (PD) than healthy and to evaluate the influence of potential confounders, including body mass index (BMI), abdominal obesity, biochemical markers, and oral hygiene habits, on periodontal status. Materials and methods A cross-sectional analytical study was conducted at the University Hospital Dr. Peset in Valencia, Spain. The case group, aged 18–45 years and PCOS diagnosed according to the Rotterdam criteria, and controls were healthy women matched by age and BMI. All participants underwent periodontal examinations, biochemical and hormonal blood analyses, anthropometric assessments, and oral hygiene habits questionnaire. Results PCOS group exhibited an altered metabolic profile, including elevated insulin levels, insulin resistance, dyslipidemia, and increased inflammatory markers, indicating a systemic pro-inflammatory state. PD were significantly more prevalent in PCOS than controls (40.5% vs. 11.2%), with higher rates of gingivitis and slightly increased periodontitis. PCOS showed greater bleeding on probing, plaque accumulation, and clinical attachment loss in PCOS. Correlation analyses revealed associations between PD and metabolic/inflammatory markers, including insulin, HDL cholesterol, hsCRP, C3c, and RBP4. Multivariate regression identified insulin and HDL cholesterol as independent predictors of periodontal inflammation, while C3c predicted plaque accumulation. CHAID analysis indicated fasting insulin as the strongest discriminator, with higher levels linked to increased PD prevalence. Conclusions PCOS is independently associated with periodontal diseases, and this relationship appears mediated by metabolic and inflammatory alterations, with insulin resistance emerging as a central mechanistic link between systemic and oral health.