Obesity Influences the Subgingival Microbiota in Periodontal Health and Disease

Objectives: Evidence suggests a relationship between periodontal diseases and obesity. Nevertheless, the impact of obesity on the subgingival microbiota has received little attention. The aim of this study was to evaluate whether obesity affects the subgingival microbial composition of individuals with periodontal health or chronic periodontitis (ChP).
Methods: Based on periodontal parameters, body mass index and waist-hip ratio, volunteers were allocated into one of the following groups: Normal weight (NW) with periodontal health (n=44), NW with ChP (n=40), Obese with periodontal health (n=40) and obese with ChP (n=42). Six subgingival biofilm samples per patient were analyzed individually for their content of 40 bacterial species using Checkerboard DNA-DNA hybridization. Microbiological data were analyzed using mixed-model ANOVA and Bonferroni tests with adjustments for age. The level of significance was set at 5%.
Results: One hundred and sixty six volunteers entered the study. Obese volunteers with ChP harbored higher levels and/or higher proportions of several periodontal pathogens than those with NW and ChP, including Aggregatibacter actinomycetemcomitans, Eubacterium nodatum, Fusobacterium nucleatum ss vincentii, Parvimonas micra, Prevotella intermedia, Tannerella forsythia, Prevotella melaninogenica and Treponema socranskii. The proportions of most of these pathogens, as well Campylobacter rectus and Eikenella corrodens were higher in the diseased sites of the obese volunteers than in those with NW. Furthermore, the healthy sites of the obese volunteers, presenting or not ChP, also exhibited higher proportions of some of the pathogens than volunteers with NW.
Conclusions: Obesity was associated with increased levels and proportions of periodontal pathogens, especially in volunteers with ChP. The negative impact of obesity in the composition of subgingival microbiota might influence periodontal breakdown. These data can help establishing preventive and treatment strategies for obese patients with ChP.