Date

June 2007

Document Type

Thesis

Degree Name

M.P.H

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Introduction: Obesity may contribute to periodontal disease, and it is unknown if this association exists in an older male cohort. It is also unknown whether there is an association between obesity measures and periodontal disease progression. Furthermore, it is unknown if the association is uniform across obesity measures and different periodontal disease definitions. This paper will address these unknowns. Materials and methods: This study was conducted among participants in the Osteoporotic Fractures in Men ("MrOS") Study, a cohort study of community dwelling US men ages 65 years and older. A subset of the MrOS cohort (N=949) underwent research periodontal exams on average 1.87 years from the baseline MrOS visit and attended a follow-up visit 2. 7 years from dental visit 1. Severe periodontitis at the dental visit 1 was defined as clinical attachment loss of ~ 5mm in 30% of teeth examined. Periodontitis progression was defined as additional clinical attachment loss of~ 3 mm in two or more teeth at follow up. Measures of obesity included Body Mass Index ("BMI"), total body fat mass, trunk fat mass, and the ratio of trunk to extremity fat. Fat mass measurements were obtained with dual energy x-ray absorptiometry (DXA). Risk ratios were calculated directly using log-binomial multivariable regression. All analyses were stratified by dental visit 1 periodontitis status (severe/not severe), and adjusted for potential confounders. Results: At the initial exam, 337 men (36°/o) had severe periodontitis. At follow-up, 313 men (33%) displayed periodontitis progression. Proportionally fewer men with severe periodontitis at dental visit 1 experienced progression (29°/o) compared to men without severe periodontitis at dental visit 1 (36°/o) (p = 0.04). After adjusting for age, geographic location, diabetes, pipe smoking, and daily walking, no associations were found between any obesity measures and periodontitis progression. For men without SP\/PrP periodontitis at dental visit 1, the adjusted risk of progression in obese men did not differ compared to men with normal body weight (Risk Vl Ratio ("RR")= 0.99, 95°/o Confidence Interval ("CI"): 0.79- 1.25). The adjusted risk of progression in overweight men without severe periodontitis at dental visit 1 also did not differ compared to men with normal body weight (RR = 0.91, 95°/o Cl: 0.68-1 .23). For men with severe periodontitis at baseline, the adjusted progression in obese men also did not differ compared to men with normal body weight (RR = 1.14, 95°/o Cl: 0.73- 1.78). The adjusted risk of progression in overweight men with severe periodontitis also did not differ compared to men with normal body weight (RR = 1. 08, 95°/o Cl : 0. 7 4- 1.58). Similarly, the adjusted risk of progression in the upper quintiles of total body fat mass, trunk fat mass, and the trunk fat to extremity fat ratio also did not differ compared to men in the lowest quintiles of these measures. Conclusions: Periodontitis progression was common in this cohort of older men. However, the results do not support the hypothesis that obesity is a risk factor for periodontitis progression in an older male cohort.

Identifier

doi:10.6083/M4B56GRK

School

School of Medicine

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