{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:53:32Z","timestamp":1780401212173,"version":"3.54.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T00:00:00Z","timestamp":1627084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T00:00:00Z","timestamp":1627084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adult obesity has been associated with various systemic diseases and is an increasing problem in Bahrain. Recent evidence indicates a correlation between adult obesity and periodontitis. Hence the aim of this study was to assess the prevalence of periodontitis in overweight\/obese adults in Bahrain and to determine the factors associated with periodontitis in these obese adults.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>This cross-sectional study was conducted in overweight subjects attending Ministry of Health (MOH) Nutrition Clinics at primary health centers in Bahrain. After obtaining the institutional ethics approval, the demographic and anthropometric data, including Body Mass Index (BMI) and waist circumference (WC) using World Health Organization (WHO) thresholds for severity of obesity, were recorded. Periodontal status was measured using the Community Periodontal Index (CPI) and the extent and severity of periodontal disease were categorized according to the number of sextants with CPI codes 3 and 4.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 372 participated with a mean age 44.0 (\u00b1\u200910.5) years for males, and 42.5 (\u00b1\u200911.2) years for females. Periodontitis was present in 361 (97%) of participants. Hypertension and diabetes were the most prevalent co-morbidities at 23.4% and 16% respectively. Mean WC was significantly greater in males at 114\u00a0cm (\u00b1\u200915.6) compared to females 109.5\u00a0cm (\u00b1\u200912.5) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). BMI was not associated with severity or extent of periodontitis but WC was weakly correlated in males but not in females (Spearman rho\u2009=\u2009\u2009+\u20090.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In the logistic regression model using overall WC to predict the severity of periodontitis, the adjusted OR was 1.02 (95% CI 1.00\u20131.04) and for age it was 1.05 (95% CI 1.00\u20131.07).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The prevalence of periodontitis was high in this sample of overweight Bahrainis. BMI was not correlated with periodontitis but WC had a weak positive correlation. Implementation of periodontal health screening as a routine part of a nutrition clinic program is recommended.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-021-01720-y","type":"journal-article","created":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T12:02:32Z","timestamp":1627128152000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence of periodontitis in obese patients in Bahrain: a cross-sectional study"],"prefix":"10.1186","volume":"21","author":[{"given":"Leena","family":"Alsalihi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crawford","family":"Bain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Milosevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Janahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gowri","family":"Sivaramakrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,24]]},"reference":[{"key":"1720_CR1","unstructured":"World Health Organization. Overweight and Obesity. Fact sheet. Available @ https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight Accessed on 30 March 2021."},{"key":"1720_CR2","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","volume":"384","author":"M Ng","year":"2014","unstructured":"Ng M, Fleming T, Robinson M. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766\u201381.","journal-title":"Lancet"},{"key":"1720_CR3","unstructured":"World Health Organization. Burden of oral disease.2004.Available @ https:\/\/www.who.int\/oral_health\/disease_burden\/global\/en\/index.html Accessed on 30 March 2021"},{"key":"1720_CR4","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1111\/jcpe.12421","volume":"42","author":"J Suvan","year":"2015","unstructured":"Suvan J, Petrie A, Nibali L, Darbar U, Rakmanee T, Donos N, D\u2019Aiuto F. Association between overweight\/obesity and increased risk of periodontitis. J Clin Periodontol. 2015;42:733\u20139.","journal-title":"J Clin Periodontol"},{"key":"1720_CR5","doi-asserted-by":"publisher","first-page":"e381","DOI":"10.1111\/j.1467-789X.2010.00808.x","volume":"12","author":"J Suvan","year":"2011","unstructured":"Suvan J, D\u2019Aiuto F, Moles D, Petrie A, Donos N. Association between overweight\/obesity and periodontitis in adults. A systematic review. Obes Rev. 2011;12:e381\u2013404.","journal-title":"Obes Rev"},{"key":"1720_CR6","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1902\/jop.2010.100321","volume":"81","author":"B Chaffee","year":"2010","unstructured":"Chaffee B, Westonn S. Association between chronic periodontal disease and obesity; a systematic review and meta-analysis. J Periodontol. 2010;81:1708\u201324.","journal-title":"J Periodontol"},{"key":"1720_CR7","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1111\/jcpe.12417","volume":"42","author":"G Nascimento","year":"2015","unstructured":"Nascimento G, Leitre F, Do L, Peres K, Correa M, Demarco F, et al. Is weight gain associated with the incidence of periodontitis? A systematic review and meta-analysis. J Clin Periodontol. 2015;42:495\u2013505.","journal-title":"J Clin Periodontol"},{"key":"1720_CR8","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1902\/jop.2005.76.11-S.2075","volume":"76","author":"R Genco","year":"2005","unstructured":"Genco R, Grossi S, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes and periodontal infections. J Periodontol. 2005;76:2075\u201384.","journal-title":"J Periodontol"},{"key":"1720_CR9","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1530\/eje.0.1480535","volume":"148","author":"J Bruun","year":"2003","unstructured":"Bruun J, Verdich C, Toubro S, Astrup A, Rihelsen B. Association between measures of insulin sensitivity and circulating levels of interleukin-8, interleukin-6 and tumor necrosis factors-alpha. Effect of weight loss in obese men. Eur J Endocrinol. 2003;148:535\u201342.","journal-title":"Eur J Endocrinol"},{"key":"1720_CR10","doi-asserted-by":"publisher","first-page":"104997","DOI":"10.1016\/j.archoralbio.2020.104997","volume":"122","author":"G Isola","year":"2021","unstructured":"Isola G, Lo Giudice A, Polizzi A, Alibrandi A, Murabito P, Indelicato F. Identification of the different salivary Interleukin-6 profiles in patients with periodontitis: a cross-sectional study. Arch Oral Biol. 2021;122:104997.","journal-title":"Arch Oral Biol"},{"key":"1720_CR11","doi-asserted-by":"publisher","unstructured":"Menini S, Iacobini C, Blasetti Fantauzzi C, Pesce CM, Pugliese G. Role of galectin-3 in obesity and impaired glucose homeostasis. Oxid Med Cell Longev. 2016;1\u20137. https:\/\/doi.org\/10.1155\/2016\/9618092.","DOI":"10.1155\/2016\/9618092"},{"issue":"3","key":"1720_CR12","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1111\/jre.12860","volume":"56","author":"G Isola","year":"2021","unstructured":"Isola G, Polizzi A, Alibrandi A, Williams RC, Lo Giudice A. Analysis of galectin-3 levels as a source of coronary heart disease risk during periodontitis. J Periodontal Res. 2021;56(3):597\u2013605.","journal-title":"J Periodontal Res"},{"key":"1720_CR13","first-page":"896","volume":"22","author":"G Isola","year":"2020","unstructured":"Isola G, Polizzi A, Alibrandi A, Williams RC, Leonardi R. Independent impact of periodontitis and cardiovascular disease on elevated soluble urokinase-type plasminogen activator receptor (suPAR) levels. J Periodontol. 2020;22:896\u2013906.","journal-title":"J Periodontol"},{"issue":"82","key":"1720_CR14","first-page":"186","volume":"2020","author":"LM Golub","year":"2000","unstructured":"Golub LM, Lee HM. Periodontal therapeutics: Current host-modulation agents and future directions. Periodontol. 2000;2020(82):186\u2013204.","journal-title":"Periodontol"},{"key":"1720_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2011\/407237","volume":"2011","author":"A Musaiger","year":"2011","unstructured":"Musaiger A. Overweight and obesity in Eastern Mediterranean Region: prevalence and possible causes. J Obesity. 2011;2011:1\u201317.","journal-title":"J Obesity"},{"key":"1720_CR16","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12903-017-0336-y","volume":"17","author":"S Kanga","year":"2017","unstructured":"Kanga S, Timonen P, Knuuttila M, Jula A, Yl\u00f6stalo P, Syrj\u00e4l\u00e4 A. Waist circumference and waist-to-height ratio are associated with periodontal pocketing- results of Health 2000 survey. BMC Oral Health. 2017;17:48. https:\/\/doi.org\/10.1186\/s12903-017-0336-y.","journal-title":"BMC Oral Health"},{"key":"1720_CR17","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1016\/S0140-6736(05)67663-5","volume":"366","author":"S Yusuf","year":"2005","unstructured":"Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi M, Commerford P, et al. Obesity and the risk of myocardial infarction in 27000 participants from 52 countries: a case-control study. Lancet. 2005;366:1640\u20139.","journal-title":"Lancet"},{"issue":"1","key":"1720_CR18","first-page":"21","volume":"34","author":"AR Hubail","year":"2012","unstructured":"Hubail AR, Culligan KG. Current prospectus on obesity in Bahrain and determination of percentage body fat range. Bahrain Med Bull. 2012;34(1):21\u20135.","journal-title":"Bahrain Med Bull"},{"key":"1720_CR19","unstructured":"Body Mass Index. World Health Organization 2008. Available @ https:\/\/www.euro.who.int\/en\/health-topics\/disease-prevention\/nutrition\/a-healthy-lifestyle\/body-mass-index-bmi15. Accessed on 4 Jan 2021"},{"key":"1720_CR20","unstructured":"Waist circumference and waist hip ratio. World Health Organization 2008. Available @ https:\/\/www.who.int\/publications\/i\/item\/9789241501491 Accessed on 4 Jan 2021"},{"key":"1720_CR21","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/j.1600-051X.2008.01345.x","volume":"36","author":"Y Khader","year":"2009","unstructured":"Khader Y, Bawadi H, Haroun T, Alomari M, Tayyem R. The association between periodontal disease and obesity among young adult in Jordan. J Clin Periodontol. 2009;36:18\u201324.","journal-title":"J Clin Periodontol"},{"key":"1720_CR22","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1902\/jop.2003.74.5.610","volume":"74","author":"M Al Zahrani","year":"2003","unstructured":"Al Zahrani M, Bissada N, Borawskit E. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 2003;74:610\u20135.","journal-title":"J Periodontol"},{"key":"1720_CR23","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12903-015-0098-3","volume":"15","author":"S Khan","year":"2015","unstructured":"Khan S, Saub R, Vaithilingam R, Safii S, Vethakkan S, Baharuddin N. Prevalence of chronic periodontitis in an obese population: a preliminary study. BMC Oral Health. 2015;15:114.","journal-title":"BMC Oral Health"},{"issue":"60","key":"1720_CR24","first-page":"15","volume":"2012","author":"P Petersen","year":"2000","unstructured":"Petersen P, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol. 2000;2012(60):15\u201339.","journal-title":"Periodontol"},{"key":"1720_CR25","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1111\/jcpe.12273","volume":"41","author":"D Ekuni","year":"2014","unstructured":"Ekuni D, Mizutani S, Kojima A, Tomofuji T, Irie K, Azuma T, et al. Relationship between increase in BMI and changes in periodontal status: a prospective cohort study. J Clin Periodontol. 2014;41:772\u20138.","journal-title":"J Clin Periodontol"},{"key":"1720_CR26","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1093\/ajcn\/44.6.739","volume":"44","author":"G Enzi","year":"1986","unstructured":"Enzi G, Gasparo M, Biondetti P, Fiore D, Semisa M, Zurlo F. Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr. 1986;44:739\u201346.","journal-title":"Am J Clin Nutr"},{"key":"1720_CR27","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.arr.2009.06.001","volume":"8","author":"J Kuk","year":"2009","unstructured":"Kuk J, Saunders T, Davidson L, Ross R. Age- related changes in total and regional fat distribution. Ageing Res Rev. 2009;8:339\u201348.","journal-title":"Ageing Res Rev"},{"key":"1720_CR28","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1902\/jop.2005.76.10.1721","volume":"76","author":"C Dalla Vecchia","year":"2005","unstructured":"Dalla Vecchia C, Susin C, Rosing C, Oppermann R, Albandar J. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol. 2005;76:1721\u20138.","journal-title":"J Periodontol"},{"key":"1720_CR29","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1111\/j.1600-051X.2009.01515.x","volume":"37","author":"D Han","year":"2010","unstructured":"Han D, Lim S, Sun B, Paek D, Kim H. Visceral fat area-defined obesity and periodontitis among Koreans. J Clin Periodontol. 2010;37:172\u20139.","journal-title":"J Clin Periodontol"},{"key":"1720_CR30","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1902\/jop.2010.100274","volume":"82","author":"E Kim","year":"2011","unstructured":"Kim E, Jin B, Bae K. Periodontitis and obesity: a study of the fourth Korean National Health and Nutrition Examination Survey. J Periodontol. 2011;82:533\u201342.","journal-title":"J Periodontol"},{"key":"1720_CR31","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1093\/ajcn\/58.4.463","volume":"58","author":"S Lemieux","year":"1993","unstructured":"Lemieux S, Prud\u2019homme D, Bouchard C, Tremblay A, Despr\u00e9s J. Sex differences in the relation of visceral adipose tissue accumulation to total body fatness. Am J Clin Nutr. 1993;58:463\u20137.","journal-title":"Am J Clin Nutr"},{"key":"1720_CR32","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/jcpe.13189","volume":"47","author":"M Sanz","year":"2020","unstructured":"Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D\u2019Aiuto F, Bouchard P, et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020;47:268\u201388.","journal-title":"J Clin Periodontol"},{"key":"1720_CR33","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1161\/CIRCRESAHA.117.308903","volume":"121","author":"P Joseph","year":"2017","unstructured":"Joseph P, Leong D, McKee M, Anand SS, Schwalm JD, Teo K, et al. Reducing the global Burden of cardiovascular disease, part 1: the epidemiology and risk factors. Circ Res. 2017;121:677\u201394.","journal-title":"Circ Res"},{"key":"1720_CR34","doi-asserted-by":"publisher","first-page":"7093","DOI":"10.1038\/s41598-020-63700-6","volume":"10","author":"J Botelho","year":"2020","unstructured":"Botelho J, Machado V, Proen\u00e7a L, et al. The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocols. Sci Rep. 2020;10:7093. https:\/\/doi.org\/10.1038\/s41598-020-63700-6.","journal-title":"Sci Rep"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01720-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-021-01720-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-021-01720-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T12:02:41Z","timestamp":1627128161000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-021-01720-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,24]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1720"],"URL":"https:\/\/doi.org\/10.1186\/s12903-021-01720-y","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,24]]},"assertion":[{"value":"5 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethics approval is taken from the Primary care ethics committee, Training Affairs, Ministry of Health, Bahrain.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent is obtained from all the participants. All methods were performed in accordance with the relevant guidelines and regulations. This study was conducted in full conformance with the principles of the \u201cDeclaration of Helsinki\u201d and Good Clinical Practice (GCP).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Leena Alsalihi declares that she has no conflict of interest. Gowri Sivaramakrishnan declares that she has no conflict of interest. Professor Crawford Bain declares that he has no conflict of interest. Professor Alexander Milosevic has no conflict of interest. Abeer Janahi has no conflict of interest. Amar Hassan has no conflict of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"376"}}