Obesity Clinical Trial
Official title:
Obesity and Oxidative Stress in Patients With Different Periodontal Status: A Cross-sectional Study
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.
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.
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Time Perspective: Cross-Sectional
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