Associations between measures of adiposity and periodontitis among older adults

Objective: To evaluate the association between measures of adiposity and periodontitis among older Puerto Rican adults.

Methods: We collected data for a cross-sectional pilot study from 146 participants, representative of adults ≥70 years living in the San Juan metropolitan area. Height, weight, waist, and hip circumference were measured in participants' homes, by trained research assistants. Periodontitis was assessed as probing depth (PD) and attachment loss (AL) measured at 4 sites on all teeth excluding 3rd molars, by trained and calibrated examiners. Periodontitis was classified by the CDC-AAP definitions for moderate (≥2 teeth with AL≥4mm or ≥2 teeth with PD≥5mm) and severe periodontitis (≥2 teeth with AL≥6mm and ≥1 tooth with PD≥5mm) and using tertiles of percent of sites with AL≥3mm. Multivariate logistic regression was used to model associations between waist circumference (WC), waist-to-hip ratio (WHR) and periodontitis.

Results: All models were adjusted for age, gender, smoking, education, diabetes status, physical activity, total fruit and vegetable intake; CDC-AAP models additionally adjusted for number of teeth. High WC (men: ≥40 vs. <40 inches, women: ≥35 vs. <35 inches) showed non-significant associations with severe periodontitis (OR=1.98, 95% CI: 0.58-6.80), moderate periodontitis (OR=4.03, 95% CI: 0.92-17.65) and comparing upper vs. lower 2 tertiles of percent of sites with AL≥3mm (OR=1.20, 95% CI: 0.50-2.91). Elevated WHR (men: ≥0.95 vs. <0.95, women: ≥0.88 vs. <0.88) showed no significant association with an increased odds of severe periodontitis (OR=1.12, 95% CI: 0.37-3.41) but was significantly associated with moderate periodontitis (OR=5.63, 95% CI: 1.44-22.06) and the upper tertile of percent of sites with AL≥3mm compared to low WHR (OR=2.41, 95% CI: 1.01-5.77).

Conclusion: These results provide evidence to support associations between central adiposity and periodontitis among older adults. These associations may be of significant public health importance in light of the aging population and high prevalence of obesity.

Support:G12RR03051,K24DE016884