Relation of the body mass index to salivary cortisol and periodontal indices in children: A comparative analysis.

BACKGROUND: Obesity is a chronic disease resulting from the interaction of genetic, environmental, socioeconomic, and behavioral factors, and is associated with the development of numerous comorbidities. Its prevalence is increasing worldwide, making obesity one of the most significant public health challenges. OBJECTIVES: The aim of the present study was to investigate the relationship between obesity and the cortisol levels and periodontal status in children. MATERIAL AND METHODS: Ninety eligible children aged 8-12 years were enrolled in the study and allocated into 3 groups: normal-weight; overweight; and obesity. After the parents completed a demographic questionnaire, the children underwent periodontal examinations and saliva collection. The salivary cortisol levels were measured using the ELISA method. Data were analyzed using ANOVA, Pearson's correlation test, the χ2 test, linear regression, and the Kruskal-Wallis test. RESULTS: The children's body mass index (BMI) was significantly associated with the salivary cortisol levels and the gingival index (GI), bleeding on probing (BoP) and periodontal probing depth (PPD) (p = 0.010, p < 0.001, p < 0.001, and p = 0.005, respectively). However, BMI was not significantly associated with father's education, mother's education, the parental smoking addiction status, total family income, the frequency of mouthwash use per week, toothbrushing frequency per day, or daily study duration (p = 0.599, p = 0.143, p = 0.480, p = 0.875, p = 0.884, p = 0.203, and p = 0.338, respectively). The salivary cortisol levels were also significantly associated with age and GI, BOP and PPD (p = 0.010, p = 0.001, p = 0.018, and p = 0.016, respectively). In the multivariable linear regression analysis, the salivary cortisol levels remained significantly associated with age (β = 0.276; p = 0.004), obesity (β = 0.269; p = 0.006), father's education level (β = 0.393; p < 0.001), and the parental smoking addiction status (β = 0.238; p = 0.026). CONCLUSIONS: The salivary cortisol levels and periodontal indices were higher in overweight and obese children. Therefore, encouraging children and adolescents to adopt a healthier lifestyle and achieve weight reduction may help reduce the salivary cortisol levels and improve periodontal health.