Obesity and Periodontal Outcomes: A Population-Based Cohort Study in Brazil.
The aim of this study is to investigate the effects of abdominal and general obesity on periodontal outcomes in a population-based cohort of Brazilian adults.



Abdominal and general obesity were assessed in the years 2009 (n = 1,720) and 2012 (n = 1,222). For abdominal obesity, a dichotomous variable was created: 1) eutrophic/lost weight or 2) obese/gained weight. For general obesity, a categorical variable was created: 1) eutrophic/lost weight; 2) gained weight; or 3) obese. Periodontal outcomes were percentage of teeth with bleeding on probing (BOP) and combination of BOP and attachment loss (AL). Hypertension was set as the mediator. Marginal structural models (MSMs) were used to estimate the controlled direct effect of obesity on periodontal outcomes.



Periodontal data were presented from 1,066 participants. The total effect model showed those with general obesity in the cohort period presented higher risk of unfavorable periodontal outcomes (rate ratio [RR]: 1.45 for AL and BOP in different teeth; RR: 1.84 for AL and BOP in the same tooth). Estimates from MSMs revealed an effect of general obesity on AL and BOP in different teeth (RR: 1.44). No effect of general obesity was noted on the percentage of BOP. Total effect of abdominal obesity increased risk of AL and BOP in different teeth (RR: 1.47), AL and BOP in the same tooth (RR: 2.77), and percentage of BOP (RR: 1.49). In a MSM, those with abdominal obesity presented greater risk of AL and BOP in the same tooth (RR: 2.16) and percentage of BOP (RR: 1.37).



Abdominal obesity has a direct effect on unfavorable periodontal outcomes in MSMs.
Postgraduate Program In Dentistry, Federal University of Pelotas, Pelotas, Brazil.|Australian Research Center for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Gustavo G
GG
Nascimento
Australian Research Center for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Karen G
KG
Peres
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide.
Murthy N
MN
Mittinty
Australian Research Center for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.|School of Dental Medicine, East Carolina University, Greenville, NC.
Gloria C
GC
Mejia
Postgraduate Program in Public Health, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
Diego A
DA
Silva
School of Medicine, Faculty of Health Sciences, University of Adelaide.
David
D
Gonzalez-Chica
Australian Research Center for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Marco A
MA
Peres
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D017622:Periodontal Attachment Loss / Q000453:epidemiology*; D010512:Periodontal Index; D016388:Tooth Loss / Q000453:epidemiology*
Causality; epidemiologic methods; longitudinal studies; nutritional status; periodontitis; risk factors