Association between lipid metabolism and periodontitis in obese patients: a cross-sectional study

Abstract

Background To investigate the association between clinical periodontal parameters of periodontitis, serum lipid metabolism markers and adipokines’ levels in patients with obesity and periodontitis. Methods A total of 112 patients admitted to Hospital of Xi’an Jiaotong University were included in this study. They were divided into normal body weight group (18.5 < body mass index, BMI < 25, n = 36), overweight group (25 ≤ BMI < 30, n = 38), and obesity group (BMI ≥ 30, n = 38) accordingly. The diagnosis of periodontitis was based on the newest international classification of periodontitis. Full-mouth clinical periodontal measurements included: plaque index, periodontal pocket depth, clinical attachment level, and bleeding on probing. Gingival crevicular fluid samples were analyzed for: Interleukin-1β, tumor necrosis factor-α, Interleukin-6 and C-reactive protein. Serum triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and glycosylated hemoglobin levels were measured. Visfatin, leptin, resistin, and adiponectin levels in serum were also measured. Results The ratio of participants without periodontitis was significantly highest in normal weight group, and the proportion of severe periodontitis (stage III and IV) was highest in obesity group. The periodontal pocket depth, clinical attachment level, and the inflammatory cytokines in gingival crevicular fluid in obesity group and overweight group were higher than those in normal body weight group. The BMI and waist-to-hip ratio (WHR) were significantly positive correlated with periodontal pocket depth and clinical attachment level. Using a Multivariate logistic regression model, periodontitis correlates to BMI, WHR, serum levels of triglyceride, total cholesterol, low density lipoprotein, and adipokines such as visfatin, leptin, and resistin. Conclusions Obesity is positively correlated with the aggravation of periodontitis. Obesity may aggravate the damage to periodontal tissue by regulating the secretion level of adipokines.

Retinol-Binding Protein 4 and Visfatin Levels in Patients with Periodontitis and Obesity/Overweight: A Systematic Review and Meta-Analysis

“…No significant difference in circulating RBP4 level was observed among participants with and without periodontitis [19,23,26] (Figure 2, SMD = 1.38; 95% CI: −0.18-2.94, p = 0.08). In addition, a significant difference in serum visfatin level was found between two groups of periodontitis participants with and without obesity, with a higher level of serum visfatin found in OP group (Figure 3, MD = 4.21; 95% CI: 2.65-5.77, p < 0.00001) [28,33].…”

“…The random effect model was selected and, in the included two studies, no significant difference in serum RBP4 level [23,26] was found between the groups of obese participants with periodontitis and systematic healthy participants without periodontal diseases (NnP) (Figure 4, SMD = 6.76; 95% CI: −5.34-18.87, p = 0.27). Furthermore, a significant difference was found in serum visfatin level between the groups of obese participants with periodontitis and systematic healthy participants without periodontal diseases A higher level of serum visfatin was found in the OP group than NnP (Figure 5, MD = 13.02; 95% CI: 7.34-18.70, p < 0.00001) [28,30,33]. The quality assessment of the included five observational studies using the Newcastle-Ottawa Scale and Cochrane-advocated ROBINS-I tools for two interventional articles are shown in Tables S2 and S3.…”

“…The Kappa score was 0.95. The selected studies were assessed for quality using the Newcastle-Ottawa Scale for included observational studies [19,26,28,30,33] and Cochrane-advocated ROB-2 tool for evaluating the risk of bias in RCTs [35,36]. For assessing risk of bias of non-RCTs, the ROBINS-I tool was used by looking into preintervention, intervention, and postintervention domains.…”

“…The sample size of these studies ranged from 50 to 231. Among the seven incorporated studies, three of them were set in Asia (China [28,30]; India [26]); meanwhile, two of them were set in Europe (Spain [23]; Germany [19]) and two of them were set in Turkey, Asia, and Europe [33,34], which reflected the relatively diverse ethnicities. Five of the included seven studies were observational studies [19,26,28,30,33].…”

“…Among the seven incorporated studies, three of them were set in Asia (China [28,30]; India [26]); meanwhile, two of them were set in Europe (Spain [23]; Germany [19]) and two of them were set in Turkey, Asia, and Europe [33,34], which reflected the relatively diverse ethnicities. Five of the included seven studies were observational studies [19,26,28,30,33]. Most of them were designed as a typical case-control form, while one study [34] was set as an interventional study as the effect of nonsurgical periodontal treatment.…”