Does Obesity in Children Express Periodontal Tissue Changes?

Several studies have shown an association between obesity, diabetes, cardiovascular diseases and periodontal disease in adults. The potential biological mechanisms for these associations remain elusive; however, the increase of adipokines (e.g., TNF-alpha) produced by adipose tissue suggests that similar inflammatory pathways are involved in the pathophysiology of these diseases. Objective: To investigate the relationship between Body Mass Index (BMI) and TNF-alpha concentration of gingival crevicular fluid (GCF) in children participating in the Québec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort. The Quality cohort is an ongoing longitudinal study investigating the natural history of obesity in Quebec children. Method: Study participants (76 girls and 102 boys) include children aged 8-10 yrs at risk of obesity and their families, living in Montreal and Quebec City (cross-sectional study). GCF was collected using PerioPaper® strips. The Periotron® 6000 recorded GCF volumes of each sample. TNF-alpha was measured in pooled samples (N=4) for each child by ELISA kit. Height and weight were measured using standardized procedures. BMI was calculated as weight/height2 (kg/m2). Sex/age-specific BMI was categorized into normal (<85thpercentile), overweight (85th-95thpercentile) and obese (³95thpercentile) defined by the 2000 US-CDC growth charts. Insulin was measured in children fasting blood samples. All measurements and samples were collected the same day. Data analysis involved descriptive and bivariate analyses. Results: 43% of children were overweight/obese. BMI and fasting insulin levels were both positively associated with TNF-alpha concentration in boys (Kruskal-Wallis test; p=0.016 and p=0.106, respectively). TNF-alpha concentration was higher in boys (1.05±1.64pg/µL) than girls (0.81±1.23pg/µL), but this finding was not statistically significant (Mann-Whitney-test; p=0.348). Our findings agreed with previous reports that men have a higher predisposition to periodontal disease. Conclusion: These findings provide support for a link between adiposity in children and TNF-alpha concentration in GCF. Increased TNF-alpha concentration in obese/overweight children could induce future periodontal tissue destruction.