Obesità, ipertensione e malattia parodontale negli adolescenti

[Machine translation] Introduction. Adipose tissue is a metabolically active endocrine complex. Its accumulation and the increase in its metabolic activity, in obese adults, causes an increase in oxidative stress and inflammation, and represents a serious risk factor for hypertension, type 2 diabetes, dyslipidemia, coronary heart disease and, according to recent studies, periodontal disease. Objectives. Evaluate if obese pediatric patients have higher blood pressure and gingival inflammation values than a similar normal-weight sample. Materials and methods. 64 subjects (34 ♀ female, 30 ♂ male), aged 10-18 years, submitted to: -oral hygiene habits questionnaire administration; -general objective examination with detection of: systo-diastolic blood pressure in the left humerus (PaosX, British Hypertension Society method), weight (undressed subjects, fasting, empty bladder), height (Cameron technique), body mass index calculation (BMI, Cool overweight/obese child chart), waist circumference (Chaoyang 2006) to assess abdominal obesity (Ob.A.); -periodontal examination with detection of soft deposits, using the Silness and Löe index (PI, 1964), and signs of gingival inflammation, using the Löe gingival index (GI, 1963) on Ramfjord teeth (1.6-2.1-2.4-3.6-4.1-4.4). The data were evaluated with the Mann Whitney U test. Results. 32 overweight subjects: average BMI 28.24 Kg/m2 + 4.31; average age 13.25 years + 2.24; 18 ♀ average age 13.39 + 2.21, 10 obese, 8 overweight; 14 ♂, average age 13.07 +2.34, 10 obese, 4 overweight; 32 subjects average BMI 18.12 kg/m2 + 2.44; age 13.64 + 1.84; 16 ♀ age 13.66 + 2.05; 16 ♂ age 13.63 + 1.67. Based on waist circumference 17 boys, age 13.17 ± 2.46, suffering from abdominal obesity (Ob.A), B.M.I 30.77 ± 4.14 kg/m2; 9 ♀ age 13.04 ± 2.30, BMI 29.84 ± 4.55 kg/m2, 8 ♂ age 13.31 ± 2.78, BMI 31.82 ± 3.63 kg/m2. The 32 normal weight and 15 overweight with abdominal circumference within the normal range were reclassified as a control group, 25 ♀ and 22 ♂, age 13.55 ± 1.89, BMI 20.89 ± 3.92 kg/m2. Ob.A. subjects were hypertensive, an average value of 140/86 mm/Hg compared to the control group (e.g. 114/74 mm/Hg), p<0.01; among 9 ♀ Ob.A. the average value of systo-diastolic blood pressure was 132/84 mm/Hg, while in the control group of 25 ♀ it was 102/72 mm/Hg (p<0.03); in the 8 ♂ OB.A. the average value of Systo-diastolic blood pressure was 149/89 mm/Hg compared to the value of 113/74 mm/Hg in the ♂ control group, p<0.01. The questionnaire did not provide sufficient significant data to express differences in oral hygiene in the various groups. Subjects with Ob.A. had insignificant PI values compared to the control group (p<0.08), on the contrary, the GI value was significantly different (p<0.01) between subjects with Ob.A. (GI=1.33 ± 0.29) and control group (GI=0.84 ± 0.50); the result was confirmed by analyzing the two groups separately: ♀ obese GI=1.33 ± 0.29, ♀ control GI=0.29 76 ± 0.48 (p<0.01); ♂ obese GI=1.33 ± 0.31, ♂ GI control=0.92 ± 0.51 (p<0.05). Conclusions. The accumulation of abdominal fat in children and adolescents is accompanied by an increase in blood pressure values and an inflammatory state of the superficial periodontium, suggesting that alterations related to fat metabolism may affect the state of gum health.