Influence of Obesity on Periodontitis Progression Is Conditional on Interleukin-1 Inflammatory Genetic Variation

• Autores: Leon M. Wilkins, Elizabeth Krall Kaye, Hwa-Ying Wang, John Rogus, Lynn Doucette Stamm, Kenneth Kornman, Raúl García
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 88, Nº. 1, 2017, págs. 59-68
• Idioma: inglés
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• Resumen

  • Background: This study evaluates whether specific patterns of interleukin (IL)-1 gene variants, known to affect periodontitis severity, influence the previously reported association between obesity and subsequent periodontitis progression in a longitudinal database. The study population included 292 men (aged 29 to 64 years at entry) from the Veterans Affairs Dental Longitudinal Study from whom DNA and dental and anthropometric endpoints were collected during multiple examinations (approximately every 3 years for up to 27 years).

    Methods: Key variables assessed included: 1) periodontitis; 2) body mass index; 3) waist circumference to height (WHTR) ratio for central adiposity; 4) age; 5) smoking; 6) glucose tolerance; and 7) two previously reported versions of IL-1 genetic patterns associated with periodontitis severity and progression. Disease progression was determined using predefined criteria that used a combination of change in classification of disease severity based on alveolar bone loss and tooth loss during follow-up. Extended Cox regression analyses were used to estimate hazards of experiencing periodontal disease progression with or without adjustments for appropriate covariates.

    Results: In hazard ratio analyses, men with WHTR >50% at baseline and positive for either IL-1 genotype version were at significantly higher risk (two-fold) for disease progression (P for interaction = 0.04). Participants positive for IL-1 genotype version 2 exhibited earlier progression (fewer years from baseline to first incidence of progression) than those who were negative (P = 0.02, adjusted for age and smoking).

    Conclusion: In this longitudinally monitored male population, observed effect of baseline central adiposity on future periodontitis progression is conditional on proinflammatory IL-1 genetic variations.

    The Centers for Disease Control and Prevention estimate 47% of Americans aged ≥30 years have periodontitis, and multiple studies show that 8% to 13% of adults across diverse populations exhibit severe generalized periodontitis.1 Although specific bacterial patterns are essential for disease initiation, some risk factors appear to influence periodontitis severity and progression.2,3 The most well-validated risk factors for severe chronic periodontitis (CP) are smoking, diabetes mellitus (DM), and interleukin (IL)-1 genetic variations.4-9 Increasing evidence supports a role for obesity and obesity-related traits in periodontitis severity and response to treatment.10-15 Previous studies using a cohort of males within the Department of Veterans Affairs Dental Longitudinal Study (VADLS) demonstrated significant relationships between obesity status and future risk of periodontitis16 and between obesity indicators (i.e., body mass index [BMI] and waist circumference to height [WHTR]) and future progression of periodontitis.17 Obesity is associated with increased systemic inflammatory burden, including higher levels of IL-1β, tumor necrosis factor-alpha (TNF-α), and IL-618-20 that have been implicated in the role of obesity in progression of type 2 DM (t2DM).21 Studies suggest that inflammation underlies the association between obesity and periodontitis.22,23 The present study uses a subset of patients followed in the VADLS up to 27 years who consented to DNA analysis and had defined risk factors for periodontitis progression. It is hypothesized that IL-1 genetic variations interact with anthropometric variables to predict periodontitis progression. The study objective is to determine whether IL-1 genetic variations influence the effect of obesity on two longitudinally measured endpoints, periodontitis progression and time to first progression event.