| Autor: |
De Pergola, Giovanni, Abbinante, Antonia, Nisio, Alessandro, Messa, Marica, Pecorella, Claudio, Martella, Mariateresa, Calabrese, Laura, Caprio, Monica, Cagiano, Raffaele |
| Zdroj: |
Nutritional Therapy & Metabolism; Apr-Jun2014, Vol. 32 Issue 2, p53-60, 8p, 1 Diagram, 1 Graph |
| Abstrakt: |
Periodontal disease is a chronic inflammatory disease of the gingival tissues, which can lead to degradation of the periodontal ligament and resorption of the surrounding bone structure. This condition is strongly associated with obesity, with an odds ratio of 1.3 in overweight and 1.8 in obese individuals. The relationship between these two variables is independent of several risk factors for both obesity and periodontal disease. Unfortunately, it is not possible to distinguish the temporal order between obesity and periodontal disease. Concerning the possible role of obesity, it is a risk factor for infections, dysregulation of the immune system, and decreased cell-mediated immune responses. On the other hand, the sum of bacterial cells in subgingival biofilm is higher in obesity, and it has been suggested that oral bacteria may be transferred to the gastrointestinal tract, where they would increase nutrient absorption and metabolic efficiency. Alternatively, bacteria could change the leptin/ ghrelin ratio, thus increasing appetite and food intake. Low-grade systemic inflammation is a feature of both periodontal disease and obesity, and either adipose tissue accumulation or the inflammatory response stimulated by the long-term presence of the subgingival biofilm (dental plaque) is responsible for systemic inflammation, which constitutes a link between obesity-periodontal disease on the one hand and insulin resistance on the other. Higher production of several cytokines by adipose tissue and inflamed subgingival tissue, in particular tumor necrosis factor-α and interleukin-6, seems to play a leading role in systemic inflammation and insulin resistance. The latter is also an important risk factor for diabetes in obese patients with periodontal disease. It is noteworthy that a healthy diet and increased levels of physical activity protect simultaneously against obesity and periodontal disease. Our preliminary findings in overweight and obese patients suggest that higher insulin levels are a clear sign of unhealthy oral conditions, and that increasing fasting blood glucose is a bad sign for gingival health, even in nondiabetic individuals. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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