Which Obesity Measure Best Predicts Periodontitis Risk?

TOPLINE:

Two newer measures of obesity that include waist circumference — weight-adjusted waist index (WWI) and waist-to-height ratio (WtHR) — may predict the risk for periodontitis better than body mass index (BMI). The better predictor, WWI, also shows a threshold effect at a higher level of obesity and in people older than 60 years.

METHODOLOGY:

• Researchers performed a cross-sectional study to evaluate the association of periodontitis with three different indicators of obesity and to identify the most clinically important indicator.
• They used data from the US National Health and Nutrition Examination Survey (NHANES) 2009-2014 and evaluated about 10,000 participants (49.5% men, 43% non-Hispanic White individuals, 20% Black individuals, 24% Mexican American and Hispanic individuals) who were ≥ 30 years old and had at least one natural tooth.
• The three obesity indicators evaluated were: WWI [waist circumference (cm)/√weight(kg)], WtHR [waist circumference (cm)/ height (cm)], and BMI (weight (kg)/ height²(m²)].
• Using the four categories of periodontitis severity according to the US Centers for Disease Control and Prevention and the American Academy of Periodontology, participants were divided into two groups — those with (severe and moderate categories; 46% prevalence) and without (mild and none) periodontitis.

TAKEAWAY:

• The waist measure indicators, WWI and WtHR, showed an increased risk for periodontitis, (adjusted odds ratio [aOR], 1.35; 95% CI, 1.25-1.45; P P
• In the positive association between WWI and periodontitis, the odds ratio for periodontitis risk jumped from 1.32 to 3.44 when WWI exceeded 12.68 cm/√kg.
• Among participants older than 60 years, the risk for periodontitis followed a J-shaped curve, with the risk increasing eightfold when WWI exceeded 12.68 cm/√kg (OR, 7.87; P = .007).

IN PRACTICE:

“WWI showed better predictive ability for periodontitis compared to BMI and WtHR,” the authors wrote. “As a novel, simple, and effective measure of obesity, the WWI may have a broader role to play.”

SOURCE:

This study was led by XingJin Chen, Guiyang Stomatological Hospital, Guiyang, China. It was published online in Scientific Reports.

LIMITATIONS:

The NHANES 2009-2014 periodontal exams included data only on participants older than 30 years with at least one natural tooth, potentially underestimating the number of people with periodontitis. Despite controlling multiple confounding variables, the effect of additional confounders could not be ruled out. The findings primarily reflected the situation of the American population and might not be generalizable to the global population.

DISCLOSURES:

The study was funded by the Guizhou Provincial Science and Technology Fund and Guiyang Science and Technology Fund. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.