Early Childhood Growth Trajectory and Periodontal Inflammation in 8-10-year-olds

Objectives: Anthropometric measures including birth weight and body mass index have been associated with adult periodontal disease. However, there is limited evidence regarding the role of childhood growth in subsequent periodontal inflammation. We estimate the extent to which childhood growth trajectories between age 0 to 2 years are associated with concentration levels of TNFα in the gingival crevicular fluid (TNFα-GCF).
Methods: We used baseline data from an ongoing prospective study, the QUALITY (Quebec Adipose Lifestyle Investigation in Youth) cohort investigating the natural history of obesity among 8-10-year-old Caucasian children living in Quebec, Canada. This analysis included 244 boys and 186 girls for whom data were available on anthropometric measures and TNFα-GCF. Anthropometric measures at birth and up to 2 years of age were collected retrospectively from the Quebec health booklets. GCF samples were collected from the gingival sulcus using a paper strip and the concentration of TNFα-GCF was determined by enzyme linked immunosorbent assay. Growth analysis of weight-for-height z-score by age was done using the ‘lcmm’ (Latent Class Mixed Model) package in R and the log of TNFα level was regressed on the resultant growth trajectories using a linear model adjusting for body mass index (BMI) of the child and mother, parents income, education status of mother, maternal age, child’s age.
Results: A three-class solution was identified in the data analysis and defined as follows: 1- expected growth; 2- high-start, low acceleration; and 3- low-start, high acceleration. In the adjusted linear model, having a class 2 or class 3 type trajectory, compared to class 1, was associated with 13.66 (95% CI:34.98-6.86) or 19.42 (95% CI: 52.51-13.68) lower concentration levels of TNFα-GCF on average, respectively.
Conclusions: The expected growth trajectory is associated with higher periodontal inflammation as represented by higher concentration levels of TNFα-GCF.