Upper body obesity, related to visceral fat accumulation, is known to increase the risk of various adult diseases, especially type 2 diabetes and cardiovascular disease. This study was conducted to clarify the relationship between upper body obesity and periodontitis. We studied 643 apparently healthy, dentulous Japanese adults who attended programs at Fukuoka Health Promotion Center. Waist-hip ratio, body-mass index (BMI), and body fat were significant risk indicators for periodontitis after adjustment for known risk factors (p < 0.002). Subjects were divided into four BMI (or body fat) categories. In only the subjects with high waist-hip ratio, higher categories of BMI (or body fat) significantly increased the adjusted risk of periodontitis, compared with subjects with low waist-hip ratios and the lowest category of BMI (or body fat). The reported relationship between cardiovascular disease and periodontitis should be reconsidered, since abdominal adiposity or visceral fat can be related to both diseases.
Banerji MA, Buckley MC, Chaiken RL, Gordon D., Lebovitz HE, Kral JG ( 1995). Liver fat, serum triglycerides and visceral adipose tissue in insulin-sensitive and insulin-resistant black men with NIDDM. Int J Obes Relat Metab Disord19:846-850.
2.
Beck JD, Slade G., Offenbacher S. (2000). Oral disease, cardiovascular disease and systemic inflammation. Periodontology 200023:110-120.
3.
Cutler CW, Shinedling EA, Nunn M., Jotwani R., Kim BO, Nares S., et al. (1999). Association between periodontitis and hyperlipidemia: cause or effect? J Periodontol70:1429-1434.
4.
Elter JR, Williams RC, Champagne Cme, Offenbacher S., Beck JD ( 2000). Association of obesity and periodontitis (abstract). J Dent Res79(Spec Iss):625.
5.
Feingold KR, Staprans I., Memon RA, Moser AH, Shigenaga JK, Doerrler W., et al. (1992). Endotoxin rapidly induces changes in lipid metabolism that produce hypertriglyceridemia: low doses stimulate hepatic triglyceride production while high doses inhibit clearance. J Lipid Res33:1765-1776.
6.
Gemmell E., Marshall RI, Seymour GJ (1997). Cytokines and prostaglandins in immune homeostasis and tissue destruction in periodontal disease. Periodontol 200014:112-143.
7.
Genco RJ (1996). Current view of risk factors for periodontal diseases . J Periodontol67:1041-1049.
8.
Goto T., Onuma T., Takebe K., Kral JG ( 1995). The influence of fatty liver on insulin clearance and insulin resistance in non-diabetic Japanese subjects. Int J Obes Relat Metab Disord19:841-845.
9.
Grossi SG, Genco RJ (1998). Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol3:51-61.
10.
Grossi SG, Ho AW (2000). Obesity, insulin resistance and periodontal disease (abstract). JDent Res79(Spec Iss):625.
11.
Grossi SG, Zambon JJ, Ho AW, Koch G., Dunford RG, Machtei EE, et al. (1994). Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol65:260-267.
12.
Hardardottir I., Grunfeld C., Feingold KR (1994). Effects of endotoxin and cytokines on lipid metabolism . Curr Opin Lipidol5:207-215.
13.
Herzberg MC, Meyer MW (1998). Dental plaque, platelets, and cardiovascular diseases . Ann Periodontol3:151-160.
14.
Hotamisligil GS, Peraldi P., Budavari A., Ellis R., White MF, Spiegelman BM (1996). IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-a- and obesity-induced insulin resistance . Science271:665-668.
15.
Hujoel PP, Drangsholt M., Spiekerman C., DeRouen TA (2000). Periodontal disease and coronary heart disease risk. J Am Med Assoc284:1406-1410.
16.
Joshipura KJ, Rimm EB, Douglass CW, Trichopoulos D., Ascherio A., Willett WC (1996). Poor oral health and coronary heart disease. J Dent Res75:1631-1636.
17.
Kinnby B., Lindberg P., Lecander I., Matsson L. (1999). Localization of plasminogen activators and plasminogen-activator inhibitors in human gingival tissues demonstrated by immunohistochemistry and in situ hybridization. Arch Oral Biol44:1027-1034.
18.
Kopelman PG (2000). Obesity as a medical problem. Nature404:635-643.
19.
Kral JG, Schaffner F., Pierson RN Jr, Wang J. ( 1993). Body fat topography as an independent predictor of fatty liver. Metabolism42:548-551.
20.
Mattila KJ, Asikainen S., Wolf J., Jousimies-Somer H., Valtonen V., Nieminen M. (2000). Age, dental infections, and coronary heart disease . JDent Res79:756-760.
21.
Nakamura T., Tokunaga K., Shimomura I., Nishida M., Yoshida S., Kotani K., et al. (1994). Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. Atherosclerosis107:239-246.
22.
Perlstein MI, Bissada NF (1977). Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol43:707-719.
23.
Rees TD ( 2000). Periodontal management of the patient with diabetes mellitus . Periodontology 200023:63-72.
24.
Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, et al. (1998). Abdominal adiposity and coronary heart disease in women. JAm Med Assoc280:1843-1848.
25.
Saito T., Shimazaki Y., Sakamoto M. (1998). Obesity and periodontitis (letter). N Engl J Med339:482-483.
26.
Saito T., Shimazaki Y., Yamashita Y., Koga T., Tsuzuki M., Sakamoto M. (1999). Association between periodontitis and exercise capacity. Periodontal Insights62(2):9-12.
27.
Shimomura I., Funahashi T., Takahashi M., Maeda K., Kotani K., Nakamura T., et al. (1996). Enhanced expression of PAI-1 in visceral fat: possible contributor to vascular disease in obesity. Nat Med2:800-803.
28.
Stallone DD (1994). The influence of obesity and its treatment on the immune system. Nutr Rev52:37-50.
29.
Stevens J., Cai J., Pamuk ER, Williamson DF, Thun MJ, Wood JL ( 1998). The effect of age on the association between body-mass index and mortality. N Engl J Med338:1-7.
30.
Tanaka S., Inoue S., Isoda F., Waseda M., Ishihara M., Yamakawa T., et al. (1993). Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. Int J Obes Relat Metab Disord17:631-636.
31.
Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS (1997). Protection from obesity-induced insulin resistance in mice lacking TNF-a function. Nature389:610-614.
32.
Vanhala MJ, Kumpusalo EA, Pitkajarvi TK, Takala JK (1997). 'Metabolic syndrome' in a middle-aged Finnish population. J Cardiovasc Risk4:291-295.
33.
Yang SQ, Lin HZ, Lane MD, Clemens M., Diehl AM (1997). Obesity increases sensitivity to endotoxin liver injury: Implications for the pathogenesis of steatohepatitis. Proc Natl Acad Sci USA94:2557-2562.
