Obesidade, doença periodontal e inflamação sistêmica: interrelações em indivíduos da coorte de nascimento de 1982. Pelotas - RS, Brasil

Abstract

Overweight and obesity are related to chronic diseases such as cardiovascular disease, hypertension, diabetes and cancer. The association between different measures of obesity and periodontal outcomes is unclear. The aims of this study were to: a) conduct a systematic review of the evidence on the association between obesity and different periodontal outcomes, b) assess the association between obesity and periodontal disease and the mediating effect of oral hygiene, systemic inflammation and carbohydrate consumption, c) evaluate the association between periodontal inflammation and systemic outcomes measured by prior C-reactive protein in young adults. A systematic review was performed in Medline, Scopus, Lilacs (BBO), SIGLE and base abstracts submitted to Congress of the International Association of Dental Research (IADR). The remaining analysis were conducted in the 1982 cohort. In 1982, the hospital births in Pelotas were identified and have been accompanied by several times, collecting information on obesity, oral health status, level of protein C –reactive and socioeconomic aspects. The systematic review identified 5246 titles and included 42 papers. The polled estimate using random effects model [1.58 (95% CI 1.41 to 1.76)] suggests the existence of an association between obesity and periodontal outcomes. Only one study evaluated selected association with gingivitis and dental calculus. Studies using measures of periodontitis [1.13 (95% CI 1.04 to 1.22)] or of periodontal disease [1.43 (95% CI 1.25 to 1.63)] were associated with obesity. Article two observed that obese individuals had higher risk of having = 2 teeth with gingival bleeding. However, after adjustment for confounders confidence interval encompassed unity [OR obese X 2 or more teeth 1.72 (95% CI 0.95, 3.11)] and the adjustment for possible mediators further reduced the OR [OR 1.38 (95% CI 0.68, 2.80)]. The risk of dental calculus among obese subjects was 10% higher [OR 1.10 (95% CI 1.02, 1.18)]. Higher number of episodes of obesity between 15 and 23 years was associated with the presence of dental calculus. Periodontal pockets was not associated with obesity. The presence of high level of C-reactive protein (3 to 10 mg / l) at 23 years is associated with a greater number of teeth with gingivitis [PR = 1.22 (95% CI 1.04, 1.44)] and the presence of calculus [PR = 1.10 (95% CI 1.03, 1.17)]. The results of this study suggest that dental calculus was associated with systemic inflammatory state prior suggesting that it may be an early manifestation of periodontal diseases.