Overweight/Obesity and Periodontitis

Abstract

Obesity and Periodontitis are two common chronic inflammatory diseases. Based upon the hypothesis that obesity associated systemic inflammation may affect susceptibility to chronic infectious diseases like periodontitis, the aim of this PhD programme was to investigate the association between overweight/obesity and periodontitis. Five studies were conducted: 1) a systematic review to summarise the current evidence on the association including a quantitative meta-analysis of odds ratios (ORs) for having periodontitis in overweight or obese individuals 2) a secondary analysis of individual patient data (n=333) ascertaining the association between overweight/obesity and the extent/severity and treatment response (2 months) of individuals with severe periodontitis 3) a case control analysis of 286 age-matched individuals to assess the odds of periodontitis diagnosis based on overweight or obese status, 4) a prospective cohort study (n=115) investigating the relationship between obesity and periodontal treatment clinical response, 5) a mechanistic study of twenty gingival specimens assessed for differential miRNAs expression between obese and normal weight individuals. Study 1 demonstrated a statistically significant association between overweight and obesity with diagnosis of periodontitis (ORs range= 1.8-2.3). In Study 2, obesity and overweight were statistically significant predictors of clinical periodontal response at 2 months (p<0.05) independently of dental plaque levels. Results from the Study 3 confirmed increased odds of diagnosis of periodontitis in overweight (OR=2.56) and obesity (OR=3.11) after adjusting for known confounders. Study 4 demonstrated that measures of body composition were predictors of poorer non-surgical periodontal treatment response (p<0.05). Study 5 confirmed statistically significant different miRNA signature profiles of gingival tissues between normal weight and obese individuals. In conclusion, this PhD programme provides evidence of a robust association between overweight/obesity and periodontitis prevalence, extent and severity, and treatment response. The results of this thesis support the classification of obesity as a risk indicator for periodontitis