Effect of body shape and inflammation on tooth loss in men and women.

OBJECTIVES: Android and gynoid adiposity is differently involved on inflammatory responses in men or women in periodontitis and tooth loss. We tested the hypothesis whether identical waist-to-hip ratios (WHR) in men and women could abolish this disparity. MATERIALS AND METHODS: Data of 2746 participants from the Study of Health in Pomerania (SHIP) were analysed. Men and women were 1:1 matched, N = 344:344, in three age strata for waist-to-hip ratio. We determined anthropometric measures, attachment loss, tooth loss and markers of systemic inflammation. RESULTS: Women matched with men by WHR had increased periodontal measures as compared to women of the general population. Nevertheless, in the matched pairs incidence risk (IRR) ratios for any tooth loss associated with elevated C-reactive protein were IRR = 2.15 (CI 1.33-3.40) and 1.04 (0.66-1.66) in men and women, respectively. Regression with tooth loss due to any cause as dependent variable showed dose dependency on C-reactive protein levels in men but not in women. The adjusted IRR associated with high C-reactive protein in men was 1.37 (CI 1.05-1.78) and 2.63 (1.58-4.38) in general and in matched subjects, respectively. CONCLUSION: Systemic inflammation was associated with tooth loss in men but not in women even in women with wide girth. Despite worsened periodontal measures and inflammation in women matched for body shape with men, these women do not lose more teeth even when they are exposed to increased markers of systemic inflammation. CLINICAL RELEVANCE: This is an attempt to disentangle the unclear relationship between obesity and periodontitis, both of them having public health relevance.