Charupinijkul Apinun, Arunyanak Sirikarn, Rattanasiri Sasivimol, Vathesatogkit Prin, Thienpramuk Lalitsara, Lertpimonchai Attawood
Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand.
Clin Oral Investig. 2022 Jan;26(1):535-542. doi: 10.1007/s00784-021-04031-2. Epub 2021 Jun 28.
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.
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.
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).
Despite the higher incidence of disease progression in the obese, obesity is not an independent risk factor for periodontitis progression.
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.
由于既往有限的队列研究结果不一致，本研究旨在评估肥胖对泰国成年人牙周炎进展的影响。
这项为期10年的回顾性队列研究纳入了泰国发电管理局（EGAT）的2216名员工。收集了他们的人口统计学、医学和牙周状况信息。牙周炎进展的受试者定义为有≥2颗牙齿出现进展。额外的近中临床附着丧失≥3 mm或基线时因重度牙周炎导致牙齿缺失用于确定牙齿水平的疾病进展情况。采用腰臀比来分类中心性肥胖。通过对年龄、性别、教育程度、收入、吸烟、饮酒、运动、糖尿病和高血压进行校正，使用多水平泊松回归来确定肥胖对牙周炎进展的影响。
10年期间牙周炎进展的累积发病率为每100人中有59.6例（95%可信区间：57.5，61.6）。单因素分析表明，肥胖受试者进展的风险比健康受试者高15%。然而，当同时分析混杂因素时，肥胖的影响不显著，风险比为0.98（95%可信区间：0.88，1.08）。
尽管肥胖者疾病进展的发生率较高，但肥胖并非牙周炎进展的独立危险因素。
肥胖和牙周炎进展有许多共同的危险因素。将肥胖作为牙周炎进展的初步筛查可能是一种替代预防方案。
