Obesity and periodontal disease: why suggest such relationship? An overview
AbstractObesity is a chronic condition that has social and economic implications for public health. It can be associated with periodontal disease since the metabolic alterations observed in that condition could have some influence in immunity. The elevated levels of lipid and glucose can be associated with periodontal disease, contributing to an exacerbated host inflammatory response, alterations in neutrophil function, and with the inhibition of macrophage growth factors, reducing tissuehealing capacity. In this way, obese individuals could have higher chances of undergoing tissue destruction in the presence of periodontal infection. On the other hand, periodontitis may be involved in alterations of lipid metabolism, since gram-negative bacteria could promote a rise in cholesterol and triglyceride levels due to chronic exposure to low levels of LPS in circulating blood, leading to the production of cytokines, which could initiate the production of lipoproteins by the liver. The objective was to review the literature about obesity and periodontal disease and provide a better understanding of their relationship.
Bulló M, Garcia-Lorda P, Megias Salas-Salvadó J. Systemic inflammation, adipose tissue tumor necrosis factor, and leptin expression. Obes Res. 2003; 11: 525-31.
Flegal KM. Excess deaths associated with obesity: cause and effect. Int J Obes. 2006; 30: 1171-2.
Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor-a in human obesity and insulin resistance. J Clin Invest. 1995; 95: 2409-15.
Dandona P, Aljada A, Bandyopadhyay A. Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol. 2004; 25: 4-7.
Cutler CW, Shinedling EA, Nunn M, Jotwani R, Kim B-O, Nares S, et al.. Association between periodontitis and hyperlipidemia: cause or effect? J Periodontol. 1999; 70: 1429-34.
Iacopino AM, Cutler CW. Pathophysiological relationships between periodontitis and systemic disease: recent concepts involving serum lipids. J Periodontol. 2000; 71: 1375-84.
Nishimura F, Murayama Y. Periodontal inflammation and insulin resistance-lessons from obesity. J Dent Res. 2001; 80: 1690-4.
Caro JF. Insulin resistance in obese and nonobese man. J Clin Endocrinol Metab. 1991; 73: 691-5.
Grossi SG. Ataque da placa dental: conexão entre doença periodontal, doença cardíaca e diabetes melito. Compend Cont Dent Educ. 2001; 22: 15-24.
Löesche W, Karapetow F, Pohl A, Phol C, Kocher T. Plasma lipid and blood glucose levels in patients with destructive periodontal disease. J Clin Periodontol. 2000; 27: 537-41.
Saito T, Shimazaki Y, Koga T, Tsuzuki M, Ohshima A. Relationship between upper body obesity and periodontitis. J Dent Res. 2001; 80: 1631-6.
Katz J, Flugelman MY, Goldberg A, Heft M. Association between periodontal pockets and elevated cholesterol and low-density lipoprotein cholesterol levels. J. Periodontol. 2002; 73: 494-500.
Grossi SG, Ho AW. Obesity, insulin resistance and periodontal disease [abstract 3854]. J Dent Res. 2000; 79(Spec issue): 625.
Saito T, Shimazaki Y, Kiyohara Y, Kato M, Iida M, Yamashita Y. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodont Res. 2005; 40: 346-53.
Noack B, Jachmann I, Roscher S, Sieber L, Kopprasch S, Lück C et al. Metabolic diseases and their possible link to risk indicators of periodontitis. J Dent Res. 2000; 71: 898-903.
Al-Zahrani MS, Bissada NF, Borawski EA. Obesity and periodontal disease in young, middle-aged and older adults. J Periodontol. 2003; 74: 610-5.
Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003; 30: 321-7.
Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol. 2005; 76: 1721-8.
Berg AH, Scherer PE. Adipose tissue, inflammation and cardiovascular disease. Circ Res. 2005; 96: 939-49.
Björntorp P. Etiology of the metabolic syndrome. In: Bray G, Bouchard C, James WPT. Handbook of obesity. 4.ed. Philadelphia: Marcel Dekker; 1998. p.573-600.
Pischon N, Heng N, Berninmoulin J-P, Kleber B-M, Willich SN, Pischon T. Obesity, inflammation and periodontal disease. J Dent Res. 2007; 86: 400-9.
The Brazilian Journal of Oral Sciences uses the Creative Commons license (CC), thus preserving the integrity of the articles in an open access environment.