Obesity and Oxidative Stress in Patients With Different Periodontal Status
Condition: Obesity; Periodontitis; Gingivitis
MeSH terms: Gingivitis; Periodontitis; Obesity
Study type: Observational

Summary: 
      The aim of the study is to evaluate the effect of obesity on periodontally healthy or
      diseased tissues.Normal weight and obese subjects were analyzed in 6 groups. Clinical
      periodontal status was determined through plaque index, gingival index, bleeding on probing,
      pocket probing depth, clinical attacment level and radiographs.

      Oxidative stress is known to contribute to various diseases by affecting cellular functions
      through the oxidation of proteins, lipids and DNA. Oxidative stress can be assessed by
      measuring the products of oxidative damage found in proteins, lipids and DNA or reductions in
      total antioxidant capacity Malondialdehyde, protein carbonyl and total antioxidant capacity
      levels are biomarkers of oxidative stress in gingival crevicular fluid.
    

Detailed description: 
      This cross-sectional study was conducted with 93 subjects (45 normal-weight, and 48 class I
      obese) recruited from the Periodontology Department at the Ondokuz Mayıs University Faculty
      of Dentistry; Endocrinology and Metabolic Diseases Department at the Ondokuz Mayıs University
      Faculty of Medicine in Turkey, between September 2012 and March 2014.

      The study protocol was approved by the Local Ethics Committee, and written informed consent
      was obtained from all study participants in accordance with the Helsinki Declaration (revised
      in 2000).

      Oxidative stress occurs when the balance between reactive oxygen species and antioxidants
      become unbalanced. OS can be determined by evaluation of oxidative damage products in
      proteins, lipids and DNA or the reduction of total antioxidant capacity.

      Malondialdehyde level is the biomarker of oxidative stress in lipids. Protein carbonyl level
      is the biomarker of oxidative stress in proteins.Total antioxidant capacity level is another
      biomarker of oxidative stress. Malondialdehyde, protein carbonyl and total antioxidant levels
      in crevicular fluid were examined by ELISA method.

      Obesity was diagnosed according to World Health Organization criteria using body mass index.
      Body mass index is defined as a person's weight, in kilograms (kg), divided by the square of
      height in meters (m), and it is classified as follows:

      ≤18.49 kg/m2: Under-weight 18.50-24.99 kg/m2: Normal-weight 25.00-29.99 kg/m2: Overweight
      30.00-34.9 kg/m2: Obesity class I 35.00-39.99 kg/m2: Obesity class II

      ≥40.00 kg/m2: Obesity class III (morbid obesity)

      Periodontal status was determined through plaque index, gingival index, bleeding on probing,
      pocket probing depth, clinical attachment level and radiographs. Periodontal status was
      classified according to criteria proposed by the 1999 International World Workshop for a
      Classification of Periodontal Disease and Conditions as either 'periodontally healthy',
      'gingivitis' or 'generalized chronic periodontitis'. Study participants were then grouped
      according to body mass index and periodontal status as follows:

      Group 1: Group normal weight +periodontally healthy subjects Group 2: Group normal weight +
      gingivitis subjects Group 3: Group normal weight + generalized chronic periodontitis subjects
      Group 4: Group obese + periodontally healthy subjects Group 5: Group obese + gingivitis
      subjects Group 6: Group obese + generalized chronic periodontitis subjects All clinical
      examinations and gingival crevicular fluid collection were performed by a single examiner.
      All laboratory procedures were performed by another researcher blinded to the study.

      A total of 108 gingival crevicular fluid samples were taken from the Group 5 (18 subjects x 6
      sites) and 90 samples from each of the remaining 5 groups (15 subjects per group x 6 sites).
      All samples were collected between 8-10 am on the day following periodontal status
      assessment. Samples were collected from the sites in the chronic periodontitis group that fit
      the following criteria: pocket probing depth≥5mm, clinical attachment level≥5mm and ≥30%
      radiographic alveolar bone loss. Accordingly, gingival crevicular fluid samples were
      collected from 2 molar teeth, 2 premolar teeth and 2 incisors. Gingival crevicular fluid
      samples were collected from the same 6 sites in the gingivitis and periodontally healthy
      groups in order to maintain consistency of sampling.
    

Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Systemically healthy 45 normal weight adults and 48 class I obese adults
      
Biospecimen description: 
      gingival crevicular fluid
    
Keywords: Obesity; oxidative stress; antioxidants; periodontal disease