Relation between Triglyceride Levels and Body Mass Index with respect to Periodontitis in Gulbarga population in India
V Patil, P Deshpande, S Desai
body mass index, lipids, obesity, periodontitis, triglycerides
V Patil, P Deshpande, S Desai. Relation between Triglyceride Levels and Body Mass Index with respect to Periodontitis in Gulbarga population in India. The Internet Journal of Dental Science. 2009 Volume 8 Number 2.
Periodontitis is an inflammatory disease resulting from the infection and interaction of specific subgingival bacterial species with components of the host immune response, influenced by many systemic factors in disease. Systemic factors play a major role in the pathogenesis and progression of periodontal disease. Many systemic factors have been implicated for periodontal disease like diabetes mellitus, obesity and coronary heart diseases (1). Overweight is recently considered as one of the risk factor for periodontal disease. There are many studies showing significant correlation between overweight and prevalence of periodontitis (2-4). Clarke et al. (1995) proposed a model in which they focused on personal risk factors like smoking, alcohol consumption and overweight/ obesity and concluded that obesity can act as risk factor for periodontal disease (5). Robert et al. (2005) also stated that increased BMI is related to severe periodontal attachment loss (6).
It has also been shown that lipid levels are directly associated with extent of periodontal destruction (7). There are many studies showing correlation between hyper-triglyceridemia and periodontal health (8, 9). Kuramitsu et al. (2003) found that
Materials and Methods
Sixty patients visiting the outpatient section, Department of Periodontics, H.K.E society’s S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India were screened and included in the study. Patients of both genders of age 18 years and above, having at least one site with both a probing depth of
Body weight in kilogram and height in meter were recorded and BMI was calculated for each individual using the formula: body weight divided by the square of height (15). Patients were divided into two group, Group – I with thirty patients of normal weight (BMI < 25 for Normal weight) and Group-II with thirty patients of overweight/ obese (BMI
Periodontal status was assessed by using Community Periodontal Index of Treatment Needs (CPITN), using a CPITN probe. All records were taken by single examiner. The highest CPITN score found among all examined sites were concluded as CPITN score for that individual.
Triglyceride levels were assessed using “Wako and the modification by Mc Gowan et al. (1983) (17) et al. method.” In these methods Triglycerides is converted into quinoneimine dye. Quinoneimine dye is formed at a rate proportional to Triglyceride concentration in the serum. Since it is a coloured compound it can be detected and quantified by a colorimeter (16,17). Patients abstained from eating or drinking, except water for 12 hrs and three millilitres of venous blood was collected using a sterile disposable syringe and the blood sample was allowed to clot, serum was extracted and stored at 4°c till it was subjected to above mentioned Triglyceride estimation test.
Mean and standard deviation were calculated for CPITN scores and tested at P-value of less than 0.05 for significance in both groups using Mann Whitney U test. Also mean and standard deviation of Triglyceride levels in each group was calculated and both groups were compared using student’s t-test. The correlation between Triglyceride levels and CPITN scores were calculated using Karl Pearson’s correlation co-efficient at a significance level of P ≤ 0.05.
Mean CPITN score in the Group-I was 3.33 with a standard deviation of 0.48 whereas the mean CPITN score in Group-II was 3.66 with a standard deviation of 0.48 as shown in Table (1).
When mean CPITN score were compared between groups, it showed that mean CPITN score was significantly greater in Group-II than that in Group-I as shown in Figure- 1.
Relationship between Triglyceride levels and CPITN scores was calculated using Karl Pearson correlation coefficient as shown in Table (2).
Mean CPITN score was significantly correlated to mean Triglyceride levels. The mean Triglyceride level in Group-I was 109.80 with a standard deviation of 71.93, and in Group- II, the mean Triglyceride level was 150.80 with standard deviation of 72.84 (Table 3).
Triglycerides levels were compared between Group-I and Group-II and found that Group- II had significantly higher amount of Triglycerides levels than Group- I (Figure-2).
Obesity is one of the recently observed risk factor for many chronic diseases like diabetes, coronary heart disease, osteoarthritis and hypertension (1). There are many studies showing that increase in the Body Mass is also one of the significant aggravating factors for periodontal disease (2-4,6). The present study also supplements the above finding that overweight individuals have increased periodontal destruction. Similarly, Al-Zahrani et al. (2003) in their study concluded that BMI and periodontitis were significantly correlated (4). There was one more study correlating smoking and obesity with periodontitis, concluding that obesity may act as an independent risk factor for periodontitis (18).
In our study we have taken patients in the age group of 18yrs and above, similar to the study done by Genco et al. (2005) (6) where they correlated obesity, diabetes and periodontal infection. In our study CPITN index was used because of its simplicity, speed and objectivity.
Lipid levels in blood have been seen as one of the important risk factors for periodontal destruction (2,4,8,9). In the present study there was a correlation between Triglyceride levels and periodontal destruction. As it has been stated earlier hyperlipidemia may trigger foaming of macrophages (10), leading to release of pre-inflammatory cytokines like Tumour Necrosis Factor-α, Interleukin 1β (11,12). These cytokines are significantly related with periodontal destruction (13,14). It has been shown that
To conclude the present study demonstrates a positive correlation between BMI and periodontal destruction as well as a positive correlation between Triglyceride levels in blood and periodontal destruction. A positive correlation between Triglyceride levels and BMI was also shown; hence it may be one of the pathways of periodontal destruction.