Inflammatory Status of Visceral Adipose Tissue in Obese Patients Related to Periodontitis Severity

Study Overview
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Brief Summary
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The research aims to compare the inflammatory status of visceral adipose tissue from obese patients depending on the presence and severity of periodontitis, in order to establish a potential causal link between the severity of the bacterial contamination and insulin resistance.

Detailed Description
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Recruitment of patients will be achieved in the department of digestive surgery. It will involve 122 patients with severe obesity undergoing bariatric surgery scheduled within the digestive surgery department. Patients recruited will be examined for evaluating the presence and severity of periodontitis, and separated into either group 1: for patients with moderate or severe periodontitis, and or group 2: for patients without or with mild periodontitis. The day before the surgery, blood sample will be collected for the analysis of circulating metabolic and inflammatory markers. Collection of stimulated saliva, periodontal sample and faeces samples (50 g) will also be carried out for bacteria determination. During the surgical procedure, a sample of visceral adipose tissue (50 g) will be collected and used for periodontal bacteria detection and inflammatory markers analyses.

Official Title
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Comparative Evaluation of the Inflammatory Status of Visceral Adipose Tissue From Obese Patients According to the Presence and Severity of Periodontitis

Conditions
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Parodontitis, Obesity, Metabolism Disorders

Intervention / Treatment
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* Other: SEVERE PERIODONTITIS
* Other: NO PERIODONTITIS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient eligible for bariatric surgery scheduled within the digestive surgery Patient affiliated to Social Security system or equivalent Exclusion Criteria: Treatment with steroids or anti-inflammatory drugs in progress (or stopped for less than one month) Patients who received antibiotics within 3 months prior to the bariatric surgery for whatever duration Dental current (or older than 3 months) Participation in another research protocol

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SEVERE PERIODONTITIS<br>Periodontal examination Biological samples collection: periodontal, saliva, blood, fecal, visceral adipose tissue | Other: SEVERE PERIODONTITIS<br>* Patients exhibiting moderate to severe periodontitis<br>|
| Other: NO PERIODONTITIS<br>Periodontal examination Biological samples collection: periodontal, saliva, blood, fecal, visceral adipose tissue | Other: NO PERIODONTITIS<br>* Patients without existing periodontitis or exhibiting mild periodontitis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inflammatory status of visceral adipose tissue from obese patients depending on the presence and severity of periodontitis | Measurements of major adipocytokines (Interleukine 6, Leptin, Adiponectin, Tumor Necrosis Factor-alpha, Monocyte Chemoattractant Protein-1, macrophage F4/80 receptor, CD11c, nuclear factor-kappa B, Toll Like Receptor 2/4 ) | Consecutively to visceral fat biopsy (day of surgery) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Detection of DNA for at least one type of periodontal pathogens in adipose tissue | Aggregatibacter actinomycetemcomitans, Fusibacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola and Tannerella forsythia | Consecutively to visceral fat biopsy (day of surgery) | 
| Description of the metabolic profile of patients relative to periodontitis severity | glycemia, insulinemia, glucose tolerance, plasma and HDL total cholesterol, triglycerides | Consecutively to periodontal examination (day before surgery) | 
| Link between adipose tissue inflammatory status, bacterial contamination and metabolic profile of patients | adipose tissue inflammatory status, periodontal bacterial contamination,diabetic disorders, lipid metabolic profile of patients | Consecutively to periodontal examination and fat biopsy (day before surgery, day of surgery) | 
| Link between the presence of periodontal pathogens in adipose tissue and their detection in saliva and plasma | Detection of antibodies directed to periodontal bacteria in saliva and plasma | Consecutively to periodontal examination and fat biopsy (day before surgery, day of surgery) |