Obesity, Body Fat Distribution and Periodontitis in Older Men

Objective: To evaluate the association between the presence of severe periodontitis, periodontitis progression and measures of obesity in older men.

Methods: Participants were recruited from the Osteoporotic Fractures in Men Study (MrOS). Dental measures were clinical attachment loss (CAL) and pocket depth (PD) for a random half-mouth (6 sites/tooth). Obesity measures were body mass index (BMI) from height and weight, and total body fat mass (TBFM), trunk fat mass (TFM), and trunk-to-extremity fat ratio (TEFR) obtained by dual energy x-ray absorptiometry. Men were followed for an average of 2.7 years. We used the CDC/AAP definition for severe periodontitis: > 2 interproximal sites with CAL ≥ 6mm and > 1 interproximal site with PD > 5mm. Periodontitis progression was defined as additional CAL of ≥ 3mm in > 2 teeth at Visit 2. We quantified the relation of obesity and body fat distribution using log-binomial regression models adjusted for age, site, race, annual dental visit, education, and smoking pack-years. Multivariable prevalence ratios (PR) were estimated in cross-sectional and risk ratios (RR) in longitudinal analyses.

Results: Dentate men (N=1,210) aged 66-95 years were recruited; 26% had severe periodontitis, 21% were obese, 51% overweight, and 28% normal weight. The adjusted PR for severe periodontitis at baseline was 0.82 (95% CI=0.70-0.97) in overweight and 0.99 (95% CI=0.82-1.21) in obese men, compared to normal weight men. Of the men who attended Visit 2 (N=1,017), 32% had periodontitis progression. The risk of progression in overweight and obese men did not differ compared to that in normal weight men (RR=0.98, 95% CI=0.80-1.21; RR=0.92, 95% CI=0.72-1.18, respectively). Prevalence of periodontitis and progression were not associated with TBFM, TFM, or TEFR and no significant trends were observed.

Conclusion: Our results do not support the hypothesis that obesity or body fat distributions are risk factors for prevalent severe periodontitis or periodontitis progression over 3 years.

Supported by NIH: UO1-AG18197, UO1-AR45580, UO1-AR45614, UO1-AR45632, UO1-AR45647, UO1-AR45654, UO1-AR45583, M01-RR00334, R01-DE14386.