Relationship between periodontal disease, obesity and insulin

The relationship between periodontal disease, obesity and insulin resistance was examined in the Third National Health and Nutrition Examination Survey (NHANES III).

People have a new reason to stick to their New Year's resolution to lose excess weight besides fitting into the latest fashion trends. Researchers from University at Buffalo found that obesity is a significant predictor for periodontal disease, independent of age, gender, race, ethnicity, and smoking. This study printed in a recent supplement to the Journal of Periodontology (JOP).

Furthermore, analysis of this national sample suggests that insulin resistance mediates the relationship between obesity and periodontal disease. It was found that the severity of periodontal attachment loss increased proportionally with increasing insulin resistance. In addition, the number of teeth lost increased significantly with increasing levels of insulin resistance. Individuals in the highest insulin resistance category lost 1.1 more teeth compared to individuals in the lowest category.

"People who have a higher body mass index produce cytokines (hormone-like proteins), that lead to systemic inflammation and insulin resistance," said Robert J. Genco, vice provost at the University at Buffalo and editor of the JOP. We propose that chronic stimulation and secretion of proinflammatory cytokines associated with periodontal infection also occurs, contributing to insulin resistance, which may further predispose to diabetes mellitus."

Genco and his research team recently showed that diabetics with periodontal disease may have greater mortality from diabetic complications such as cardiovascular disease and kidney complications than diabetics with little or no periodontal disease.

"The presence of periodontal infection combined with obesity may contribute to type 2 diabetes and its complications, such as coronary heart disease," said Kenneth A. Krebs, DMD and AAP president. "Although further studies are needed, people should remember that living a healthy lifestyle along with daily brushing and flossing and visiting your oral health care provider is always in fashion."