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, TNFα 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.