Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross-sectional study

Aim: We explored the association between obesity and periodontitis with the aim of determining the possible role of insulin resistance (IR) in this relationship. Materials and Methods: A total of 212 subjects-110 obese and 102 lean individuals-were evaluated for periodontal disease and divided according to IR: a lean group without IR (LWIR), an obese group without IR (OWIR), and an obese group with IR (OIR). Anthropometric, metabolic, inflammatory and periodontal parameters were evaluated. Results: Periodontitis was more prevalent in obese (80.9%) than in lean subjects (41.2%), with the former group showing a risk of periodontitis sixfold that of the latter. Obese subjects as a whole displayed higher diastolic blood pressure, TNF alpha and hsCRP and lower HDL cholesterol than lean subjects. OIR had higher systolic blood pressure, glucose, insulin, HOMA-IR, A1c, triglycerides and number of teeth with PD >= 4 mm than OWIR, while other periodontal variables remained unaltered. The multivariable regression model showed that probing depth, bleeding on probing and HOMA-IR were independent predictors of number of teeth with PD >= 4 mm. Conclusion: Our data support an association between obesity and periodontitis, and point to a central role of IR. Periodontitis tends to be more extensive in obese patients with IR.