Influence of Adiposity on Serum Biomarkers Following Periodontal Therapy

Objectives: Consistent evidence suggests a negative impact of adiposity on periodontitis and the response to periodontal therapy. The aim of this analysis was to investigate the association between obesity and inflammatory/metabolic biomarkers in a sample of patients with severe periodontitis before and after treatment.
Methods: One hundred fifteen adults with severe periodontitis (57 BMI obese and 58 BMI normal) who were non-smokers received an intensive session of non-surgical periodontal therapy (IPT). Periodontal status was based upon probing pocket depths (PPD), clinical attachment levels (CAL), and full mouth gingival bleeding (FMBS) assessed by one calibrated examiner. Serial fasting blood samples were collected at baseline, the day of treatment, and Day 1, Day 7, 2 and 6 months after IPT. C-reactive protein (CRP), insulin, glucose (HOMA indices were calculated post-hoc), lipid fractions (including total Cholesterol, LDL, HDL and Triglycerides) were assessed by standard and high sensitivity assays. Comparison within/between groups over time were made using multiple linear regression analyses.
Results: Obese patients exhibited greater CRP levels at baseline and 6 months after therapy compared to normal-weight patients (p<0.01 for both). During the acute phase following IPT, obese patients showed a two-fold greater acute increase of serum CRP (p<0.001 at Day 1 and Day 7) and acute reductions in total and LDL-Cholesterol levels (p<0.05 at Day 1 and Day 7). Lower HDL and greater Triglycerides, insulin, glucose levels and HOMA indices were noted throughout the study between obese and normal-weight patients. Correlation analyses confirmed a statistical association between visceral fat score (p<0.05), serum CRP (p<0.05), insulin levels (p<0.01) and HOMA indices (p<0.01) and most clinical periodontal parameters at baseline, 2 and 6 months after IPT.
Conclusions: Obesity was independently associated with greater serum inflammatory and metabolic responses following non-surgical periodontal therapy in patients with severe periodontitis.