J Clin Periodontol 2003; 30: 321–327 Copyright r Blackwell Munksgaard 2003

Printed in Denmark. All rights reserved

Comparison of body composition Nelson Wood, Roger B. Johnson,

and Charles F. Streckfus
Department of Periodontics, University of
Mississippi School of Dentistry, Jackson, MS,
and periodontal disease using USA

nutritional assessment
techniques: Third National Health
and Nutrition Examination Survey
(NHANES III)
Wood N, Johnson RB, Streckfus CF: Comparison of body composition and periodontal
disease using nutritional assessment techniques: Third National Health and Nutrition
Examination Survey (NHANES III). J Clin Periodontol 2003; 30: 321–327. r
Blackwell Munksgaard, 2003.

Abstract
Objectives: The objective of this study was to investigate the association of body
composition (obesity) and periodontal disease using simple, inexpensive nutritional
assessment techniques available in the Third National Health and Nutrition
Examination Survey (NHANES III).
Material and Methods: Caucasian subjects, aged 18 years and above, participating in
NHANES III, were used for this study. Weight, height, waist circumference, hip
circumference, skinfold thickness (S), and bioelectrical impedance analysis
measurements were performed and used in the calculation of body mass index (BMI),
waist-to-hip ratio (WHR) (visceral fat), log sum of S (subcutaneous fat), and fat-free
mass (FFM). Data were analyzed using SPSSs. One-way, factorial ANOVA,
multivariate analyses, and regression curve analyses were performed. po0.05 was
used to reject the null hypothesis.
Results: Adjusting for age, gender, history of diabetes, current smoking, and
socioeconomic status, statistically significant correlations were found between
periodontitis and WHR, BMI, FFM, and in some instances S.
Conclusion: This study, indicating significant correlations between body composition
and periodontal disease (with WHR being the most significant, followed by BMI, Key words: periodontitis; body composition;
FFM, and S), showed similarities to those observed in other obesity-related health waist-to-hip ratio; body mass index; free-fat
problems. This strengthened arguments that periodontal disease and certain obesity- mass; skinfold thickness
related systemic illnesses are related, with abnormal fat metabolism possibly being an
important factor. Accepted for publication 4 April 2002

Obesity, the most common nutritional
disorder in America (Kopelman 2000),
is a significant risk factor for numerous
adult diseases, and may be a factor in
the incidence of periodontitis. Body
mass index (BMI) (Elter et al. 2000,
Grossi & Ho 2000, Wood & Johnson
2001), waist-to-hip circumference ratio
(WHR), body fat, and maximum oxygen
consumption (Saito et al. 1998, 2000,
2001) may be factors in the incidence of
this disease.
Conditions associated with obesity,
e.g. ‘‘the metabolic syndrome’’, a
clustering of dyslipidemia and insulin
resistance (Vanhala et al. 1997) may
exacerbate periodontitis (Grossi & Ho
2000). Long-term interest in the role of
nutrition and periodontal disease (Rus-
sell et al. 1961, Russell 1963, Oles
1966, Alfano 1976, Muroff et al. 1979,
Carlos & Wolfe 1989) questions the role
of nutrients in periodontal disease
pathogenesis (Carlos & Wolfe 1989).
322 Wood et al.
The Third National Health and Nutri-
tion Examination Survey (NHANES III)
includes a thorough nutritional status
assessment. The relationship between
various chronic diseases and body
composition has been recognized, and
there has been considerable interest in
assessing body composition in health
examinations for nationally representa-
tive population samples. The reasons for
the use and inclusion of anthropometric
measurements and bioelectrical impe-
dance analysis (BIA) to assess nutri-
tional status, to collect comprehensive
socioeconomic and demographic infor-
mation, and to administer food-fre-
quency questionnaires and a detailed
24-h recall have been described in the
literature (Kuczmarski 1996). These are
simple, inexpensive methods for esti-
mating fat-free mass (FFM), percent
body fat, and location of body fat that
may be used outside the laboratory
(Segal et al. 1988, Kyle & Pichard
2000). Many investigators have devel-
oped empiric BIA equations for the
prediction of FFM, total body weight,
and body fat (Lukaski et al. 1985, 1986,
Segal et al. 1985, 1988, Kushner &
Schoeller 1986, Van Loan & Mayclin
1987, Jackson et al. 1988, Lukaski &
Bolonchuk 1988, Graves et al. 1989,
Heitmann 1990, Deurenberg et al. 1990,
1991, Roubenoff et al. 1997).
Human body fat content may influ-
ence morbidity and mortality (Stevens
et al. 1998), and its measurement and
location may provide useful information
about various disease states. Most large
epidemiological studies that have ex-
amined body composition have used
Quetelet’s Index of Obesity (BMI (kg/
m2)). BMI is a determinant for over-
weight (but not necessarily obesity),
while the WHR determines the amount
of visceral fat (also called abdominal fat
or upper body obesity). Skinfold thick-
ness (S) measurements have been
shown to be an accurate measurement
of subcutaneous fat at a given location,
and evidence supports the notion that
the log sum of several skinfold sites is a
good measure of total subcutaneous fat
in men (Durnin & Womersly 1974,
Jackson & Pollock 1977, 1978, Lohman
1981) and women (Jackson et al. 1980).
Several other fat deposits exist in
addition to subcutaneous fat, including
intermuscular fat, intramuscular fat and
fat around the visceral organs and
gastrointestinal tract of the body (peri-
renal, mesenteric, and omental), essen-
tial lipids in bone marrow, and central
nervous system and other organs. Thus,
there may be a considerable chance for
biological variation in body fat distribu-
tion (Johnson et al. 1972).
Periodontitis, a chronic inflammatory
oral disease, may have profound effects
on systemic health by affecting the host
susceptibility to systemic disease due to
accumulation of Gram-negative bacteria
and inflammatory mediators (Herzberg
& Meyer 1996, Beck et al. 1998,
Herzberg & Weyer 1998, Dorn et al.
1999, Iacopino & Cutler 2000). Period-
ontal status has been reported to be a
significant, independent predictor of
mortality (Garcia et al. 1998, Arbes et
al. 1999).
Therefore, it seems reasonable to
investigate the associations between
various nutritional assessment techni-
ques, BMI, WHR, lean body mass for
males (LBMm), lean body mass for
females (LFMf), FFM, which use the
published-BIA prediction equations of
Kyle (Kyle et al. 2001) and Lukaski
(Lukaski et al. 1985, 1986, Lukaski
1989), and skinfold thickness (the log
sum of three skinfold thicknesses (S)
(tricep S1subscapular S1suprailiac S)
which determine fat content and loca-
tion in the human body and (1) various
periodontal disease indices (periodontal
attachment loss (PAL), percentage
(PAL%) and mean (PALm) (2) mean
pocket depth (PDm), (3) mean gingival
bleeding index (GBm), and (4) mean
calculus index (CIm). Our hypothesis is
that the incidence and severity of
periodontal disease is greater in obese
subjects as compared to subjects with
normal weight.
Material and methods
Data for this study were obtained from
NHANES III, conducted from 1988 to
1994, designed to provide estimates of
the health status of the United States’
civilian, noninstitutionalized population
aged 2 months and over (Ezzati et al.
1992). For this analysis, three public-
use data files–household adult (DHHS)
1996a), examination (DHHS) 1996a),
and clinical laboratory data (DHHS)
1996b) – were obtained from a CD-
ROM and merged into one data file
(DHHS 1997). We chose to limit this
study to the Caucasian population, aged
18 years and above, due to race speci-
ficity and possible limitations of the
existing BIA equations. It is presently
unknown whether race-specific equa-
tions for African-American, Hispanic-
American, and Native American popu-
lations would significantly improve the
accuracy of BIA in these groups.
The independent variable of interest
was the percent of periodontal sites per
subject with an attachment loss (PAL)
of X3 mm. Periodontal examinations
were conducted in the mobile examina-
tion centers by six calibrated dentists
trained in the use of epidemiological
indices for oral health (Arbes et al.
1999). For this study, extent scores
(Carlos et al. 1986), representing the
percent of sites per subject with an
attachment loss of X3 mm, were calcu-
lated and separated into three groups.
Normal subjects had 0–33% of sites
with PAL X3 mm; while subjects with
early periodontitis had 33–66% of sites
with PAL X3 mm; and subjects with
severe periodontitis had 67–100% of
sites with PAL X3 mm. A threshold of
3 mm was used to increase the like-
lihood that attachment loss was the
result of disease and not measurement
error. The analysis excluded persons
who were edentulous. Other periodontal
indices that were examined were
PALm, PDm, GBm indices, and CIm.
Established risk factors for period-
ontal disease and obesity were selected
as covariables. The covariables were
age, gender, smoking status (current
smoker), a history of diabetes (self-
reported by ‘‘Has the doctor ever told
you that you have diabetes?’’), and
socioeconomic status (poverty income
ratio (unimputed income)).
Weight was measured in kilograms
(kg), height in centimeters (cm), and
BMI in kg/m2. Waist circumference
measurements were taken at the level
of the umbilicus in centimeters (cm),
and hip measurements were taken at the
greatest circumference of the buttocks
area in centimeters (cm). Waist circum-
ference measurements were divided by
hip circumference measurements to
obtain the WHR. The measurement of
S (cm) was made at specific subscapu-
lar, tricep, and suprailiac sites (Lukaski
1987). A licensed physician supervised
all measurements. Total body resistivity
and reactance were measured with a
four-terminal portable impedance ana-
lyzer (RJL Systems, Detroit, MI, USA)
(Lukaski et al. 1985). Resistance (R) to
the flow of a 50-kHz injected current
was measured on a 0–1000 O scale and
reactance (Xc) was measured on a
0–200 O scale. Empirically derived
formulas provided by the manufacturer
 Body composition and periodontal disease 323

Table 1. Pearson correlation coefficients (r) among bioelectrical impedance analysis (BIA) published (PUB) prediction equations, and the
manufacturer’s (MAN) BIA prediction equations (n 5 17,660)
Fat-Free MassPUB Fat-Free MassPUB Lean body Lean body
(Kyle et al. 2001) (Lukaski 1986, 1989) mass menMAN mass womenMAN

Fat-Free MassPUB 0.990 0.958 0.989

(Kyle et al. 2001)
Fat-Free MassPUB 0.963 0.978
(Lukaski et al. 1986, Luskaski 1989)
Lean body mass menMAN 0.985
po0.001 for all correlations.

Table 2. Characteristics of the study population. mean7SEM (n)

Age Categories (years)

Characteristics Gender 18–34 35–49 50–64 651

Age (years) Male 26.070.1 (2225) 41.470.1 (1457) 57.570.1 (1164) 75.870.2 (1765)
Female 25.970.1 (2299) 41.370.1 (1590) 57.370.1 (1185) 75.870.2 (1879)
Weight (kg) Male 5771 (2203) 5671 (1447) 5671 (1161) 5571 (1751)
Female 4971 (2279)n 4971 (1577)n 4971 (1175)n 5071 (1857)n
Height (cm) Male 15771 (1969) 15671 (1278) 15671 (1026) 15571 (1532)
Female 14771 (2021)n 14771 (1403)n 14671(1044)n 14771 (1683)n
BMI (kg/m2) Male 23.770.1(1954) 23.470.2(1273) 23.370.2(1026) 23.370.2(1526)
Female 23.570.2(2008) 23.670.2(1395) 23.870.2(1037) 23.670.2(1665)
WHR Male 0.94970.002(1851) 0.94970.002(1202) 0.94870.003(960) 0.94870.002(1452)
Female 0.88670.002(1894)n 0.88870.002(1305)n 0.88470.002(978)n 0.88770.002(1570)n
Resistance (O) Male 49472 (1270) 49572 (821) 49873 (671) 49672 (970)
Female 60172 (1237)n 60173 (862)n 59773 (618)n 59973 (1021)n
Reactance (O) Male 65.270.4(1269) 64.770.5(821) 65.470.5(670) 65.670.4(969)
Female 72.970.4 (1236)n 73.070.5(861)n 72.970.6(618)n 73.370.5(1020)n
Log sum S Male 1.6070.01(1836) 1.5970.01(1180) 1.5970.01(948) 1.597.01(1427)
Female 1.7070.01(1852)n 1.7170.01(1285)n 1.7070.01(960)n 1.727.01(1543)n
FFMBIAPUB
K 50.970.2(2492) 50.670.3(1676) 50.970.3(1285) 50.570.2(1979)
n
Po0.05 for gender.
BMI 5 body mass index (kg/m2), WHR 5 waist circumference to hip circumference ratio, log sum S 5 log
sum of skinfold thickness (tricep1subscapular1suprailiac), FFMBIAPUB
K 5 fat-free mass using a published prediction equation (Kyle et al. 2001).

of the BIA instrument were used to
calculate estimated LBM for men
(LBMm) and women (LBMf) (Segal et
al. 1988). Formulas are described in the
Appendix.
Pearson correlation coefficients (r)
comparing FFM using BIA required
prediction equations of Kyle (Kyle et
al. 2001), Lukaski (Lukaski et al. 1986,
Lukaski 1989), and the manufacturer’s
BIA prediction equations of LBMm and
LBMf n 5 17,660. Due to the very high
multicolinearity between these equa-
tions (all r’s40.957), we decided to
use the new Geneva BIA equation for
the prediction of FFM of Kyle (Kyle et
al. 2001) (FFMBIA-K), which has been
validated using dual X-ray absorptome-
try (DXA) (r 5 0.986–0.987) in healthy
adults aged 22–94 years with BMIs
between 17.0 and 33.8 kg/m2 (Kyle et
al. 2001) (Table 1). From hereon, FFM
refers to fat-free mass derived from
FFMBIA-K.
Data were analyzed using SPSSs
version 10.1. Initially, periodontitis
(PAL) severity and BMI, WHR, S, and
FFM were compared by one-way
and factorial analysis of variance. In
all multivariate analyses, adjustments
were made for age, gender, smoking
status, history of diabetes, and socio-
economic status. In the logistic regres-
sion models for goodness-of-fit, the
following variables were recoded: gen-
der was recoded as male (code 1) and
female (code 0); history of diabetes,
(yes (code 1), no (code 0)); and current
smoking history, (yes (code 1), no (code
0)). Regression curve analyses were
performed for all periodontal indices
and compared to nutritional assessment
data. po0.05 was used to reject the null
hypothesis.
Results
Characteristics of the study population
(mean7sem) are presented in Table 2.
Male subjects were significantly hea-
vier, taller, and had higher WHRs than
female subjects in each age category,
while R, Xc, and S were significantly
higher in all female age categories
(po0.05). Our study demonstrated that
an increasing percentage of PAL was
significantly associated with WHR
(F 5 253.32) and BMI (F 5 19.65) at
po0.01, and FFM (F 5 4.11) at
po0.05, but not S (Table 3). However,
adjusted PALm was significantly corre-
lated with WHR (0.2459) BMI (0.1512),
and S (0.0866) at po0.01, but not FFM.
Adjusted PDm scores were significantly
correlated with WHR (0.1596), BMI
(0.1306), and S (0.1100) at po0.01, but
not FFM. Adjusted GBm scores were
324 Wood et al.

Table 3. Comparison of body composition and periodontal attachment loss (PAL) severity
Mean7SEM (n)
a
% PAL of X3 mm per subject Age cats. total n 18–34 35–49 years 50–64 years 651years
Male1Female Male1Female Male1Female Male1Female

BMI (Kg/m2)
0–33 3426 25.570.1 (1599) 27.770.2 (939) 28.170.2 (503) 27.270.2 (385)
3985 25.470.1 (1784) 27.970.2 (1099) 28.170.2 (608) 26.970.2 (494)
33–66 471 25.670.8 (30) 27.070.5 (79) 27.770.4 (154) 26.870.3 (208)
444 28.471.9 (12) 28.670.9 (51) 28.670.6 (112) 26.770.3 (269)
67–100 319 25.070.2 (2) 28.771.1 (37) 26.870.4 (98)** 26.370.3 (182)**
197 28.771.6 (23) 29.171.0 (46) 25.970.5(128)
WHR (cm)
0–33 3328 0.91570.002 (1559) 0.97170.002 (910) 1.00370.003 (489) 1.01170.003(370)
3879 0.84070.002 (1745) 0.86870.003 (1064) 0.90470.003 (593) 0.92670.003 (477)
33–66 454 0.93470.010 (30) 0.98770.007 (78) 1.00370.005 (149) 1.01470.005(197)
329 0.89670.023 (11) 0.88970.011 (51) 0.91370.007 (110) 0.92370.006 (157)**
67–100 297 1.00570.035 (2) 1.00870.017 (36)* 1.01370.008 (93) 1.01570.004 (166)
187 0.90770.013 (21) 0.93870.012 (44)** 0.94770.007 (122)**
S
0–33 3246 1.7070.01 (1536) 1.7770.01 (878) 1.7870.02 (470) 1.7470.02 (362)
3353 1.8370.01 (1687) 1.9570.02 (1019) 1.9470.02 (574) 1.8470.02 (73)
33–66 438 1.7470.08 (29) 1.7170.04 (73)** 1.7470.02 (142) 1.6870.01 (194)
313 2.1670.25 (11) 1.9570.08 (46) 2.0270.06 (104) 1.8270.04 (152)
67–100 291 1.6970.12 (2) 1.8270.09 (35)* 1.7170.02 (92) 1.777.01 (162)*
184 1.8870.11 (19) 1.9570.08 (45) 1.8170.04 (120)
FFMBIAPUB
K (Kg)
0–33 6806 52.170.2 (2992) 53.770.2 (1943) 52.970.3 (1050) 49.470.4 (821)
33–66 749 55.271.4 (41) 54.570.9 (122) 54.370.7 (242) 50.070.6 (344)
67–100 477 59.073.5 (2) 56.371.7 (56) 54.570.9 (132) 49.770.6 (287)
BMI 5 body mass index (kg/m2); WHR 5 waist circumference (cm) to hip circumference (cm) ratio; S 5 log 10 sum of (tricep S1subscapular
S1suprailiac S); FFMBIAPUB
K 5 free-fat mass (kg) 5
4.1041(0.518  height2/resistance)1(0.231  weight)1(0.130  reactance)1(4.229  sex:
men 5 1, women 5 0).
a
%PAL 5 percent of sites with periodontal attachment loss of X3 mm per subject.
*po0.01; **po0.05 for same gender.

Table 4. Adjusteda-Pearson correlation coefficients (r) among body composition and various DISCUSSION
periodontal indices in Caucasians (df 5 1,011)
Periodontal Pocket depth Gingival bleeding Calculus index Visceral fat accumulation (abdominal
attachment (mean) (mean) (mean) obesity) that is observed in upper body
loss (mean) obesity (WHRX0.8 for females and
X0.9 for males) is associated with more
BMI 0.1512n 0.1306n 0.0945n 0.1770n health problems than lower body obe-
WHR 0.2459n 0.1596n 0.2081n 0.2510n
sity (Nakamura et al. 1994, Banerji et al.
Log sum of S 0.0866n 0.1100n 0.0413 0.1270n
FFMBIA
K 0.0553
0.0560 0.1872n
0.0687nn 1995, Rexrode et al. 1998) and sub-
cutaneous fat (Nakamura et al. 1994),
n
po0.01; nnpo0.05. BMI 5 Body mass index (kg/m2), WHR 5 waist-to-hip circumference ratio, regardless of BMI (Rexrode et al. 1998).
Log sum of S 5 log sum of skinfold thickness (tricep1subscapular1suprailiac), FFMBIA
K 5 fat-
Our data demonstrate that this pattern
free mass using a published prediction equation (Kyle et al. 2001).
a also exists for periodontal disease.
Adjusted for age, gender, a history of diabetes, a history of current smoking, and socioeconomic
status. When the percent of PALX3 mm per
site per subject was compared to upper
body obesity (WHR), BMI, FFM, and
significantly correlated with WHR showed a steep incline at GBm (0–0.71), subcutaneous fat (represented by the log
(0.2081), FFM (0.1872) and BMI with BMI increasing from 18 to 25 kg/m2 sum of S), our data show that WHR has
(0.0945) at po0.005, but not S. Ad- over this distance, and the curve then the highest F ratio (F 5 253.32), fol-
justed CIm were significantly correlated leveled off. Also, S versus GBm showed a lowed by BMI (F 5 19.651) and FFM
with WHR (0.2510), BMI (0.1770), and steep incline from GBm 0 to 0.40 (F 5 4.11); subcutaneous fat (S) was not
S (0.1270) at po0.01, and FFM increasing from 1.38 to 1.80 over this significant. Also, adjusted-PALm, PDm,
(
0.0687) at po0.05. All correlations distance, and then the curve leveled off GBm, and CIm correlations show a
were adjusted for age, gender, a history and eventually turned downward. On the similar pattern, with WHR demonstrat-
of diabetes, current smoking, and socio- CIm versus FFM curve, the FFM ing the highest Pearson (r) correlation,
economic status (Table 4). (mean 7 sem) started out small toward followed by BMI, then S, and FFM.
Regression curve estimations showed, the left side of the curve, and steadily Thus, the patterns of fat distribution
dramatic changes. BMI versus GBm increased as the CIm increased (Table 5). in terms of periodontal pathogenesis

Table 5. Regression curve estimations without the constant term (x3 5 R2)
Periodontal Pocket depth
attachment (mean)
loss (mean)
BMI 0.956 0.960
WHR 0.983 0.988
Log sum of S 0.944 0.949
FFMBIA
K 0.955 0.961
All curves are cubic (x3), and all correlation coefficients are squared (R2).
Po0.001 for all correlations.
follow those observed with other obe-
sity-related health problems. Upper
body fat localization is a significant risk
factor for type II diabetes, dyslipidemia,
hypertension seen in the ‘‘metabolic
syndrome’’ (Grossi & Genco 1998),
along with various cancers. This
strengthens the argument that period-
ontal disease and certain systemic ill-
nesses are related, and that fat
metabolism may play a key role in
these relationships.
An additional important finding in
this study was that of the nonlinear
relationships between various period-
ontal disease indices and the nutritional
assessment data utilized in this study.
The categorizing and/or grouping
data in studies of this type may lead to
very misleading results, and curve
extrapolations cannot be trusted in these
cases.
Obesity has been shown to affect host
immunity (Tanaka et al. 1993, Stallone
1994). Obese, hypertensive rats have
been shown to have a higher incidence
of periodontitis than normal rats, and
have intimal periodontal blood vessel
thickening, indicating diminished blood
flow (Perlstein & Bissada 1977). The
plasminogen-activating system has been
shown to play an important role in
gingival inflammation (Kinnby et al.
1999). Plasminogen activator inhibitor-
1 (PAI-1) has an increased gene expres-
sion in visceral fat (Shinomura et al.
1996) and induces agglutination of
blood, increasing the risk for ischemic
vascular disease. Thus, PAI-1 may also
decrease periodontal blood flow in
obesity, promoting initiation of period-
ontitis and progression.
Hyperlipidemia frequently accompa-
nies infectious diseases (Feingold et al.
1992, Hardardottir et al. 1994), and a
single dose of bacterial endotoxin (li-
popolysaccharide (LPS)) can induce
liver adipose tissue-lipid metabolic
changes (Feingold et al. 1992). Gram-
Body composition and periodontal disease
Gingival bleeding Calculus index
(mean) (mean)
0.797 0.762
0.810 0.778
0.772 0.744
0.775 0.756
negative LPSs from periodontal pockets
can mediate adipose tissue TNF-a
release, and it may possibly be asso-
ciated with hepatic dyslipidemia, which
would result in various obesity-related
health problems. An association be-
tween periodontitis and hyperlipidemia
has been reported (Cutler et al. 1999),
and periodontal treatment has been
shown to have a favorable effect on
diabetic control (Grossi & Genco 1998).
Tumor necrosis factor alpha (TNF-a),
recently reported in adipose tissue, has
been shown to cause liver injury in
obese patients (Yang et al. 1997), and
to be directly associated with insulin
resistance (Hotamisligil et al. 1996,
Uysal et al. 1997). It also has an effect
on cytokines and prostaglandins in
periodontal tissue (Gemmell et al.
1997). All these factors indicate
a periodontitis–dyslipidemia relation-
ship.
Body fat distribution – ‘‘where fat?’’
in addition to ‘‘how fat?’’ – is likely to
be a critical epidemiological factor in
diseases of the oral cavity. The associa-
tion between these diseases and the role
of fat should be investigated in more
detail.
Appendix
Manufacturer’s prediction equation:
LBMm ¼ 6:493
þ0:4936ðheight2 =resistanceÞ
þ0:332ðweightÞ;
LBMf ¼ 5:091
þ0:6483ðheight2 =resistanceÞ
þ0:1699ðweightÞ:
A new Geneva BIA equation valid for
the prediction of FFMBIA
K with dual
X-ray absorptometry (DXA)
(r 5 0.986–0.987) in healthy adults aged
22–94 years with BMIs between 17.0
325
and 33.8 kg/m2 (Kyle et al. 2001):
FFMBIA
K ¼
4:104
þð0:518height2 =
resistanceÞ
þð0:231weightÞ
þð0:130reactanceÞ
þð4:229sex : men ¼ 1;
women ¼ 0Þ:
FFMBIA
L was also calculated with the
following equation of Lukaski (Lukaski
et al. 1986, Lukaski 1989), which has
been validated with hydrodensitometry
(Lukaski et al. 1986):
FFMðkgÞ ¼
4:03 þ 0:734ðHt2 =RÞ
þ0:116ðweightÞ þ 0:096ðXcÞ
þ0:984ðsexÞ;
where Ht is height in cm, R is resistance
in O, weight is in kg, Xc is reactance in
O, and sex 5 0 for women and 1 for men.
Zusammenfassung
Vergleich von Körperzusammensetzung und
Parodontitis mittels Techniken der Ernährung-
serfassung: Dritte Nationale Studie zur Ge-
sundheitheits- und Ernährungserfassung
(NHANES III)
Zielsetzung: Untersuchung der Zusammen-
hänge zwischen Körperszusammensetzung
(Fettleibigkeit) und Parodontitis mittels einfa-
cher, kostengünstiger Techniken zur Ernäh-
rungserfassung, die im Rahmen der dritten
Nationalen Studie zur Gesundheitheits- und
Ernährungserfassung (NHANES III) zugänglich
waren.
Material und Methoden: Individuen kauka-
sischer Abstammung im Alter von X 18 Jahren,
die an der NHANES III teilnahmen, wurden
untersucht. Gewicht, Körpergröe, Bauch- und
Hüftumfang, Hautfaltendicken- (S) und BIA-
Messungen wurden erhoben und zur Berech-
nung des Körpermassenindex (BMI), der
Bauch-zu-Hüften-Relation (WHR) (viszerales
Fett), log der Summe von S (Unterhautfett) und
freie Fettmasse (FFM) verwendet. Die Daten
wurden mittels SPSSs ausgewertet. Einseitige,
faktoriale ANOVA, multivariate Analysen und
Regressionskurvenanalysen wurden durchge-
führt. Po0,05 wurde festgelegt, um die Null-
hypothese zu verwerfen.
Ergebnisse: Nach Korrektur für Alter,
Geschlecht, Vorgeschichte von Diabetes, ak-
tuellem Rauchen und sozioökonomischem Sta-
tus wurden statistisch signifikante
Korrelationen zwischen Parodontitis und
WHR, BMI, FFM und in manchen Fällen S
gefunden.
Schlussfolgerungen: Diese Studie zeigte sig-
nifikante Zusammenhänge zwischen Körperzu-
sammensetzung und Parodontitis; dabei war
WHR der wichtigste Faktor gefolgt von BMI,
FFM und S. Dies zeigt Parallelen zu anderen
mit Fettleibigkeit einhergehenden Gesundheit-
sproblemen und stärkt die Argumentation, dass
326 Wood et al.
Parodontitis und bestimmte systemische Erk-
rankungen in Verbindung stehen, die mit
Fettleibigkeit einhergehen, wobei ein abnorma-
ler Fettstoffwechsel möglicherweise ein wichti-
ger Faktor ist.
Résumé
Comparaison entre la composition corporelle et
la maladie parodontale. En utilisant des
techniques d’estimation nutritionnelle. Troi-
sie`me enqueˆte nationale d’examen de la sante´ et
de la nutrition. (NHANES III)
Objectifs: L’objectif de cette étude était
d’étudier l’association entre la composition
corporelle (Obésité) et la maladie parodontale
en utilisant des techniques de mises en
évidences nutritionnelles peu onéreuses et
simples disponibles dans le troisième bilan de
l’examen national de santé et de nutrition.
(NHANES III).
Matériels et Méthodes: des sujets caucasiens
âgés de 18 ans et plus, et ayant participé à
NHANES III, furent utilisés pour cette étude.
Le poids, la taille, le tour de taille, le tour de
hanche, l’épaisseur des plis de la peau (S) et des
mesures du BIA furent utilisés pour le calcul de
l’indice de masse corporel (BMI), le ratio taille-
hanche (WHR)(graisse viscérale), log des
sommes des S (graisses sous-cutanées), et
masse de graisse libre (FFM). Les données ont
été analysées par SPSSs. Des analyses multi-
variées ANOVA factoriel, à sens unique, et des
analyses de courbe de régression ont été
réalisées. Po0.05 a été utilisé pour rejeter
l‘hypothèse nulle.
Résultats: En ajustant pour l’âge, le sexe,
l’historique de diabète, la condition tabagique et
socio-économique, des corrélations statistique-
ment significatives ont été trouvées entre la
parodontite et WHR, BMI, FFM, et aussi
parfois avec S.
Conclusion: cette étude indique des corréla-
tions significatives entre la composition corpor-
elle et la maladie parodontale. WHR est le
facteur le plus significatif suivi de BMI, FFM et
S, et il y a des similarités avec d’autres
problèmes de santé en relation avec l’obésité.
Ceci renforce les arguments selon lesquels la
maladie parodontale et des maladies systém-
iques en relation avec l’obésité sont associées,
avec comme facteur important une anomalie du
métabolisme graisseux.
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Address:
Nelson Wood
Department of Periodontics
University of Mississippi School of
Dentistry
2500 North State Street
Jackson, MS 39216-4505, USA
Fax:11 601 984 6120
e-mail: nwood@sod.umsmed.edu