Apinun Charupinijkul1, Sirikarn Arunyanak1,2, Sasivimol Rattanasiri3, Prin Vathesatogkit4, Lalitsara Thienpramuk5, Attawood Lertpimonchai6,7. 1. Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. 2. Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand. 3. Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 4. Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 5. Medical and Health Division, Electric Generation Authority of Thailand, Nonthaburi, Thailand. 6. Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. attawood.l@chula.ac.th. 7. Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand. attawood.l@chula.ac.th.
Abstract
OBJECTIVE: Due to inconsistent findings in limited previous cohort studies, the aim of this study was to estimate the obesity effect on periodontitis progression in Thai adults. MATERIALS AND METHODS: This 10-year retrospective cohort study comprised 2216 employees of the Electric Generation Authority of Thailand (EGAT). Their demographic, medical, and periodontal status was collected. Subjects with periodontitis progression were defined as having ≥ 2 teeth with progression. Additional proximal clinical attachment loss ≥ 3 mm or tooth loss with severe periodontitis at baseline were used to identify disease progression at the tooth level. Central obesity was classified using the waist-hip ratio. Multi-level Poisson regression was used to determine the effect of obesity on periodontitis progression by adjusting for age, sex, education, income, smoking, alcohol drinking, exercise, diabetes mellitus, and hypertension. RESULTS: The cumulative incidence of periodontitis progression during the 10-year period was 59.6 cases per 100 persons (95% CI: 57.5, 61.6). The univariate analysis indicated that obese subjects had 15% higher risk of progression than that of healthy subjects. However, when confounders were analyzed simultaneously, the effect of obesity was not significant with a risk ratio of 0.98 (95% CI: 0.88, 1.08). CONCLUSIONS: Despite the higher incidence of disease progression in the obese, obesity is not an independent risk factor for periodontitis progression. CLINICAL RELEVANCE: Obesity and periodontitis progression share many common risk factors. Using the obesity as a preliminary screening for periodontitis progression may be an alternative prevention protocol.
OBJECTIVE: Due to inconsistent findings in limited previous cohort studies, the aim of this study was to estimate the obesity effect on periodontitis progression in Thai adults. MATERIALS AND METHODS: This 10-year retrospective cohort study comprised 2216 employees of the Electric Generation Authority of Thailand (EGAT). Their demographic, medical, and periodontal status was collected. Subjects with periodontitis progression were defined as having ≥ 2 teeth with progression. Additional proximal clinical attachment loss ≥ 3 mm or tooth loss with severe periodontitis at baseline were used to identify disease progression at the tooth level. Central obesity was classified using the waist-hip ratio. Multi-level Poisson regression was used to determine the effect of obesity on periodontitis progression by adjusting for age, sex, education, income, smoking, alcohol drinking, exercise, diabetes mellitus, and hypertension. RESULTS: The cumulative incidence of periodontitis progression during the 10-year period was 59.6 cases per 100 persons (95% CI: 57.5, 61.6). The univariate analysis indicated that obese subjects had 15% higher risk of progression than that of healthy subjects. However, when confounders were analyzed simultaneously, the effect of obesity was not significant with a risk ratio of 0.98 (95% CI: 0.88, 1.08). CONCLUSIONS: Despite the higher incidence of disease progression in the obese, obesity is not an independent risk factor for periodontitis progression. CLINICAL RELEVANCE: Obesity and periodontitis progression share many common risk factors. Using the obesity as a preliminary screening for periodontitis progression may be an alternative prevention protocol.
Authors: Ashkan Afshin; Mohammad H Forouzanfar; Marissa B Reitsma; Patrick Sur; Kara Estep; Alex Lee; Laurie Marczak; Ali H Mokdad; Maziar Moradi-Lakeh; Mohsen Naghavi; Joseph S Salama; Theo Vos; Kalkidan H Abate; Cristiana Abbafati; Muktar B Ahmed; Ziyad Al-Aly; Ala’a Alkerwi; Rajaa Al-Raddadi; Azmeraw T Amare; Alemayehu Amberbir; Adeladza K Amegah; Erfan Amini; Stephen M Amrock; Ranjit M Anjana; Johan Ärnlöv; Hamid Asayesh; Amitava Banerjee; Aleksandra Barac; Estifanos Baye; Derrick A Bennett; Addisu S Beyene; Sibhatu Biadgilign; Stan Biryukov; Espen Bjertness; Dube J Boneya; Ismael Campos-Nonato; Juan J Carrero; Pedro Cecilio; Kelly Cercy; Liliana G Ciobanu; Leslie Cornaby; Solomon A Damtew; Lalit Dandona; Rakhi Dandona; Samath D Dharmaratne; Bruce B Duncan; Babak Eshrati; Alireza Esteghamati; Valery L Feigin; João C Fernandes; Thomas Fürst; Tsegaye T Gebrehiwot; Audra Gold; Philimon N Gona; Atsushi Goto; Tesfa D Habtewold; Kokeb T Hadush; Nima Hafezi-Nejad; Simon I Hay; Masako Horino; Farhad Islami; Ritul Kamal; Amir Kasaeian; Srinivasa V Katikireddi; Andre P Kengne; Chandrasekharan N Kesavachandran; Yousef S Khader; Young-Ho Khang; Jagdish Khubchandani; Daniel Kim; Yun J Kim; Yohannes Kinfu; Soewarta Kosen; Tiffany Ku; Barthelemy Kuate Defo; G Anil Kumar; Heidi J Larson; Mall Leinsalu; Xiaofeng Liang; Stephen S Lim; Patrick Liu; Alan D Lopez; Rafael Lozano; Azeem Majeed; Reza Malekzadeh; Deborah C Malta; Mohsen Mazidi; Colm McAlinden; Stephen T McGarvey; Desalegn T Mengistu; George A Mensah; Gert B M Mensink; Haftay B Mezgebe; Erkin M Mirrakhimov; Ulrich O Mueller; Jean J Noubiap; Carla M Obermeyer; Felix A Ogbo; Mayowa O Owolabi; George C Patton; Farshad Pourmalek; Mostafa Qorbani; Anwar Rafay; Rajesh K Rai; Chhabi L Ranabhat; Nikolas Reinig; Saeid Safiri; Joshua A Salomon; Juan R Sanabria; Itamar S Santos; Benn Sartorius; Monika Sawhney; Josef Schmidhuber; Aletta E Schutte; Maria I Schmidt; Sadaf G Sepanlou; Moretza Shamsizadeh; Sara Sheikhbahaei; Min-Jeong Shin; Rahman Shiri; Ivy Shiue; Hirbo S Roba; Diego A S Silva; Jonathan I Silverberg; Jasvinder A Singh; Saverio Stranges; Soumya Swaminathan; Rafael Tabarés-Seisdedos; Fentaw Tadese; Bemnet A Tedla; Balewgizie S Tegegne; Abdullah S Terkawi; J S Thakur; Marcello Tonelli; Roman Topor-Madry; Stefanos Tyrovolas; Kingsley N Ukwaja; Olalekan A Uthman; Masoud Vaezghasemi; Tommi Vasankari; Vasiliy V Vlassov; Stein E Vollset; Elisabete Weiderpass; Andrea Werdecker; Joshua Wesana; Ronny Westerman; Yuichiro Yano; Naohiro Yonemoto; Gerald Yonga; Zoubida Zaidi; Zerihun M Zenebe; Ben Zipkin; Christopher J L Murray Journal: N Engl J Med Date: 2017-06-12 Impact factor: 91.245