Zhang Hui, Ren Zhengyun, Peng Xi, Guo Tailin
College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China; School of Materials Science and Engineering, Key Laboratory of Advanced Technologies of Materials Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan, China.
College of Life Science, Southwest Jiaotong University, Chengdu, Sichuan, China.
Int Dent J. 2025 Jun 10;75(4):100832. doi: 10.1016/j.identj.2025.04.012.
Periodontitis is a highly prevalent chronic inflammatory disease affecting periodontal tissues. While the Body Roundness Index (BRI), has emerged as a novel anthropometric measure for evaluating obesity-related health risks, its relationship with periodontal health remains unexplored. Although systemic inflammation is recognized as a key role in both obesity and periodontitis. However, whether BRI affects periodontitis, the mediating role of systemic inflammation in BRI-related periodontitis has not been elucidated.
Data were derived from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, comprising 8415 participants aged ≥18 years. We analysed BRI's correlation with periodontal disease using binary logistic regression models. Restricted Cubic Spline (RCS) modelling explored nonlinear patterns. The predictive performance of BRI for periodontitis was compared with traditional anthropometric indices using Receiver Operating Characteristic (ROC) curves. Mediation models assessed how systemic inflammation (SII, SIRI) bridges the BRI-periodontitis link.
In the fully adjusted model, participants in higher BRI quartiles showed progressively increased odds of periodontitis compared with those in the lowest quartile (Q1), with odds ratios of 1.33 (95% CI: 1.07-1.65, P = .010) for Q2, 1.48 (95% CI: 1.16-1.88, P = .004) for Q3, and 1.70 (95% CI: 1.20-2.40, P = .010) for Q4. RCS analysis indicated a linear relationship between BRI and periodontitis risk (nonlinearity P = .201). ROC curves revealed that BRI demonstrated superior predictive performance for periodontitis compared to BMI. The mediation analysis indicated that SII (5.37%, 95% CI: 0.86%-15.02%, P < .001) and SIRI (8.92%, 95% CI: 2.73%-22.13%, P < .05) partially mediated the BRI-periodontitis association.
Our study demonstrates that elevated BRI is positive associated with an increased risk of periodontitis. Systemic inflammation, as reflected by SII and SIRI, partially mediates this relationship.
Body Roundness Index (BRI), has emerged as a novel anthropometric indicator that more precisely estimates visceral adiposity and body fat percentage. Obesity, particularly the dysfunction of adipose tissue in visceral obesity, leads to the secretion of many pro-inflammatory factors, triggering systemic inflammatory responses. Systemic inflammation is recognized as a key role in both obesity and periodontitis. However, whether BRI affects periodontitis, the mediating role of systemic inflammation in BRI-related periodontitis has not been elucidated. This study supports that BRI is significantly associated with an increased risk of periodontitis, and systemic inflammation partially mediates this relationship. These findings highlight the importance of addressing obesity and systemic inflammation as part of periodontal disease prevention and management strategies.
牙周炎是一种影响牙周组织的高度流行的慢性炎症性疾病。虽然身体圆润度指数（BRI）已成为评估肥胖相关健康风险的一种新型人体测量指标，但其与牙周健康的关系仍未得到探索。尽管全身炎症被认为在肥胖和牙周炎中都起着关键作用。然而，BRI是否会影响牙周炎，全身炎症在与BRI相关的牙周炎中的中介作用尚未阐明。
数据来源于2009 - 2014年美国国家健康与营养检查调查（NHANES），包括8415名年龄≥18岁的参与者。我们使用二元逻辑回归模型分析BRI与牙周疾病的相关性。限制立方样条（RCS）建模探索非线性模式。使用受试者工作特征（ROC）曲线将BRI对牙周炎的预测性能与传统人体测量指标进行比较。中介模型评估全身炎症（SII、SIRI）如何连接BRI与牙周炎之间的联系。
在完全调整模型中，与最低四分位数（Q1）的参与者相比，处于较高BRI四分位数的参与者患牙周炎的几率逐渐增加，Q2的比值比为1.33（95%CI：1.07 - 1.65，P = 0.010），Q3为1.48（95%CI：1.16 - 1.88，P = 0.004），Q4为1.70（95%CI：1.20 - 2.40，P = 0.010）。RCS分析表明BRI与牙周炎风险之间存在线性关系（非线性P = 0.201）。ROC曲线显示，与BMI相比，BRI对牙周炎具有更好的预测性能。中介分析表明，SII（5.37%，95%CI：0.86% - 15.02%，P < 0.001）和SIRI（8.92%，95%CI：2.73% - 22.13%，P < 0.05）部分介导了BRI与牙周炎之间的关联。
我们的研究表明，升高的BRI与牙周炎风险增加呈正相关。SII和SIRI所反映的全身炎症部分介导了这种关系。
身体圆润度指数（BRI）已成为一种新型人体测量指标，能更精确地估计内脏脂肪过多和体脂百分比。肥胖，尤其是内脏肥胖中脂肪组织的功能障碍，会导致许多促炎因子的分泌，引发全身炎症反应。全身炎症被认为在肥胖和牙周炎中都起着关键作用。然而，BRI是否会影响牙周炎，全身炎症在与BRI相关的牙周炎中的中介作用尚未阐明。本研究支持BRI与牙周炎风险增加显著相关，且全身炎症部分介导了这种关系。这些发现凸显了在牙周疾病预防和管理策略中解决肥胖和全身炎症问题的重要性。
