The association between periodontal pathogens and measures of adiposity

Objectives: Whilst an association between periodontitis and obesity has been described, a possible association between subgingival periodontal pathogens and obesity is less clear. This study investigated associations between the presence of periodontal disease pathogens and various measures of adiposity in a group of 60-70 year old men.

Methods: A cross-sectional analysis was performed on 642 dentate men enrolled on a longitudinal study of cardiovascular disease in Northern Ireland. A comprehensive periodontal examination, including subgingival plaque sampling, was performed. Body mass index, waist circumference, waist-to-height ratio and waist-to-hip ratio were analysed as dependent outcome variables in multiple linear regression models. The detectable presence of four subgingival periodontal pathogens (Aggregatibacter Actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella Forsythia) at different detection thresholds were entered as predictive variables with adjustment for the various confounders.
Results: The mean age of the men studied was 63.7 (SD 3.0) years. Of the 642 men, 347 (54%) were classified as being overweight (BMI 25-29.9 kg/m²), and 144 (22.4%) as obese (BMI ≥30 kg/m²). At a detection threshold of 1x10³ bacteria, the mean BMI of the 178 men that had Porphyromonas gingivalis was 28.0 (SD 3.6) kg/m² compared to 27.3 (SD 3.6) kg/m² for men that did not, p=0.03. Multiple linear regression analysis showed the detectable presence of Porphyromonas gingivalis was significantly associated with an increased BMI p=0.03, waist circumference p=0.04, and waist-to-height ratio p=0.02, after adjustment for age, CRP, smoking, socio-economic status, cholesterol and diabetes. There were no associations between the presence of the other bacteria and measures of adiposity.

Conclusions: In these 60-70 year old dentate men, the presence of Porphyromonas gingivalis in subgingival plaque was significantly associated with an increased BMI, waist circumference, and waist-to-height ratio after adjustment for known confounders.