Competing interplay between systemic and periodontal inflammation: obesity overrides the impact of oral periphery
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ORIGINAL ARTICLE
Competing interplay between systemic and periodontal inflammation: obesity overrides the impact of oral periphery Peter Meisel 1
&
Christiane Pink 1 & Vinay Pitchika 1 & Matthias Nauck 2,3 & Henry Völzke 3,4 & Thomas Kocher 1
Received: 2 July 2020 / Accepted: 6 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives We aimed at investigating whether the interaction between the local inflammation, periodontitis, and obesity is independently associated with systemic inflammation. Methods From the population-based Study of Health in Pomerania, 3366 participants, without (2366) and with (1000) obesity, were studied for the association of periodontitis, measured as probing depth (PD) and plaque together with body mass index (BMI) on C-reactive protein (CRP). Quantile regression was used to evaluate the association between periodontal, anthropometric, and inflammatory variables (outcomes). Results The overall prevalence of obesity in this adult population was 31.4% in men and 28.1% in women. Both PD and plaque were positively associated with CRP, revealing an increasing impact across the CRP concentration distribution. Adjusting the regression of CRP or fibrinogen on PD for waist circumference attenuated but did not abolish the PD coefficients. Dental plaque was similarly associated with these interrelations. Association between PD and a dental plaque was different among participants with low-, medium-, or high-risk CRP concentrations. Conclusion Local and systemic sources of inflammation contribute to blood levels of inflammatory markers. The respective contributions depend on the relative rate in each of the inflammation-inducing risks and are dominated by adiposity. Clinical relevance Keeping systemic inflammation low in order to prevent age-related disease sequelae. Keywords Obesity . Periodontitis . Inflammation . C-reactive protein
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03514-y) contains supplementary material, which is available to authorized users. * Peter Meisel [email protected] 1
Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475 Greifswald, Germany
2
Institute of Clinical Chemistry and Laboratory Diagnostics, Greifswald, Germany
3
DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
4
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
Periodontitis is an inflammatory chronic disease of the gum leading to attachment loss and bone destruction. Periodontal disease may eventually result in tooth loss and is associated with systemic inflammatory diseases. Various studies of the recent decade offer facts and correlations between obesity and periodontitis, which appear controversial and often difficult to explain at first glance. Nevertheless, it is obvious that obesity is associated with
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