Association between periodontitis and different insulin resistance indices in hypertensive patients: a multicenter cross-sectional study

Insulin resistance (IR) is closely related to metabolic dysfunction and systemic inflammation, both of which may contribute to periodontitis. However, the association between different IR indices and periodontitis in patients with hypertension remains insufficiently characterized. This study aimed to evaluate the associations of six IR indices with periodontitis among hypertensive patients. This multicenter cross-sectional study included 12,028 patients with hypertension. Multivariable logistic regression models were used to assess the association between IR and periodontitis, with restricted cubic splines (RCS) applied to explore potential nonlinear patterns. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to assess the discriminatory performance and net benefit of the IR indices in the current study population. Among the 12,028 participants, 2213 had periodontitis. Patients with periodontitis had higher levels of all six IR indices. In fully adjusted models, each 1-SD increase in TG/HDL-C, TyG, TyG-WC, TyG-BMI, METS-IR, and METS-VF was associated with higher odds of periodontitis, with ORs of 1.16, 1.18, 1.28, 1.34, 1.36, and 1.53, respectively. Similar increasing trends were observed across quartiles. METS-VF showed the highest observed AUC of 0.669. Higher IR indices were positively associated with the prevalence of periodontitis in hypertensive patients. Further longitudinal studies are needed to clarify the temporal relationship and clinical implications of these associations.