The authors declare that they have no competing interests.
HSP and HSN conceived of the study, and participated in its design and helped to draft the manuscript. HSS carried out the weight control program. SJH carried out the assay of periodontal biomarker and oral examination, and performed statistical analysis. All authors participated in the writing process, read and approved the final manuscript.
HSP: PhD candidate, Chungnam National University, SouthKorea. HSN: Professor, Chungnam National University, SouthKorea. HSS: Professor, Konyang University, South Korea. SJH: Professor, Konyang University, South Korea
Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. Exercise training in high fat mice or rats can inhibit gingival inflammation effectively. The objective of this human intervention study was to investigate whether short-term weight control could affect periodontal indexes and serum and gingival crevicular fluid (GCF) biomarkers in young Koreans.
Forty-one obese volunteers (body mass index (BMI) > 25.0) and 12 normal weight subjects (18.5 ≤ BMI ≤ 23.0) participated in a four-week weight control program to analyze the changes in anthropometric criteria, the concentrations of C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides in serum, gingival index, bleeding on probing, periodontal biomarkers in GCF, and dental plaque index at the first and the 27th days.
The means of obesity measures decreased significantly more in the obese group (BMI 2.53 ± 0.96, waist-to-hip ratio (WHR) 4.88 ± 1.58 %, LDL 35.85 ± 21.74 mgdL−1) than in the normal weight group (BMI 0.78 ± 0.72, WHR 2.00 ± 0.95 %, LDL 15.58 ± 18.07 mgdL−1). While the obese group showed significant decreases in the biomarkers in GCF (IL-1β 58.38 ± 65.55 pgmL−1, MMP-8 4.19 ± 5.61 ngmL−1, MMP-9 3.36 ± 6.30 ngmL−1), the mean changes for the normal weight group (IL-1β 10.07 ± 21.08 pgmL−1, MMP-8 1.49 ± 4.61 ngmL−1, MMP-9 -1.52 ± 9.71 ngmL−1) were not statistically significant. Anthropometric measures and the amounts of GCF biomarkers had weak positive correlations (0.242 ≤ r ≤ 0.340), and LDL in serum correlated with MMP-8 (r = 0.332) and IL-1β (r = 0.342) in the obese group. Stepwise multiple linear regression analysis in the obese group showed that the relationship between the amount of IL-1β in GCF and predictor variables including LDL and BMI was highly significant and accounted for 19.1 % of the variance in IL-1β in GCF.
In periodontally healthy subjects, weight control could reduce the amounts of MMP-8, MMP-9, and IL-1β in GCF of the obese subjects. Further studies with periodontally unhealthy and obese people are needed to identify the mechanism of decreases in inflammation biomarkers in GCF through weight control.
Griggiths GS. Formation, collection and significance of gingival crevice fluid. Periodontol 2000. 2003;31:32–42. CrossRef
Janket S, Jones JA, Meurman JH, Baird AE, Van Dyke TE. Oral infection, hyperglycemia, and endothelial dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:73–179. CrossRef
Jimenez M, Hu FB, Marino M, Li Y, Joshipura KJ. Prospective associations between measures of adiposity and periodontal disease. Obesity (Silver Spring). 2012;20:1718–25. CrossRef
Kawanishi N, Yano H, Yokogawa Y, Suzuki K. Exercise training inhibits inflammation in adipose tissue via both suppression of macrophage infiltration and acceleration of phenotypic switching from M1 to M2 macrophages in high-fat-diet-induced obese mice. Exerc Immunol Rev. 2010;16:105–18. PubMed
Khosravi R, Ka K, Huang T, Khalili S, Nguyen BH, Nicolau B, et al. Tumor necrosis factor- α and interleukin-6: potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediators Inflamm. 2013;2013:728987. CrossRefPubMedPubMedCentral
Mäkelä M, Salo T, Uitto VJ, Larjava H. Matrix metalloproteinases(MMP-2 and MMP-9) of the oral cavity: cellular origin and relationship to periodontal status. J Dent Res. 1994;73:1397–406. PubMed
Marchetti E, Monaco A, Procaccini L, Mummolo S, Gatto R, Tetè S, et al. Periodontal disease: the influence of metabolic syndrome. Nutr Metab. 2012;9:88. CrossRef
Morel O, Luca F, Grunebaum L, Jesel L, Meyer N, Desprez D, et al. Short-term very low-calorie diet in obese females improves the haemostatic balance through the reduction of leptin levels, PAI-1 concentrations and a diminished release of platelet and leukocyte-derived microparticles. Int J Obes. 2011;35:1479–86. CrossRef
Östberg AL, Bengtsson C, Lissner L, Hakeberg M. Oral health and obesity indicators. BMC Oral Health. 2012;20:50. CrossRef
Palle AR, Reddy CM, Shankar BS, Gelli V, Sudhakar J, Reddy KK. Association between obesity and chronic periodontitis: a cross-sectional study. J Contemp Dent Pract. 2013;14:168–73. PubMed
Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Periodontol. 2008;35:277–90. CrossRef
Taguchi A, Tsuda M, Ohtsuka M, Nakamoto T, Inagaki K, Noguchi T, et al. Interaction of obesity and skeletal bone mineral density in tooth retention in Japanese postmenopausal women. Menopause. 2007;14:500–4. PubMed
- Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: a pilot study
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