Abstract
Subjects
In 2001, 1586 subjects from a metropolitan area of Porto Alegre, Brazil, who were aged > 14 years were interviewed and examined. For the present study, in 2006 and 2007, 755 individuals from the original cohort were interviewed and examined again. Subjects (n = 582) with no history of diabetes, at least 6 teeth, and a body mass index (BMI) of at least 18.5 kg/m(2) were included in the study. The subjects were 57% female and 43% male. Thirty percent of the subjects were overweight (BMI: 25-29.9 kg/m(2)), and 19% were obese (BMI >= 30.0 kg/m(2)). About half of the subjects (51%) received regular dental care (>= 5 dental visits during the follow-up period), and 39% received irregular dental care.
Key Risk/Study Factor
The key risk factor analyzed in this study was BMI at the time of the baseline interview and examination in 2001. BMI was calculated as the ratio of the body weight (kg) to the square of the height (m) for each subject. Subjects were divided into 3 categories based on BMI: normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (>= 30 kg/m(2)), with underweight subjects excluded from the analysis.
Main Outcome Measure
The primary outcome of this study was periodontal attachment loss (PAL) progression during the follow-up period between 2001 and 2006/2007. PAL was assessed by measuring the distance from the cementoenamel junction to the bottom of the pocket/sulcus. The periodontal probing depth was combined with the gingival recession measurements. PAL progression was defined as proximal PAL of at least 3 mm in 4 or more teeth.
Main Results
At 5-year follow-up, PAL progression occurred in 38% of the subjects, including 31% of normal weight subjects, 42% of overweight subjects, and 50% of obese subjects. After adjusting for cofactors, obese subjects were significantly more likely to experience PAL progression (relative risk [RR] = 1.36, 95% confidence interval [CI] = 1.04-1.78, P = .02) compared to normal weight subjects. However, when the subjects were stratified by sex, obesity was associated with PAL progression in women (RR = 1.64, 95% CI = 1.11-2.43, P = .01) but not men (RR = 1.13, 95% CI = 0.75-1.69). The increase in PAL progression in subjects in the overweight category was not statistically significant overall or in either sex.
Conclusions
In this study, obesity was a risk factor for PAL progression in this population in a developing country. The authors found that the increased risk was significant only in women. They conclude that the current longitudinal study confirms the cross-sectional results previously reported for this cohort.(1)