Gender differences in the association between tooth loss and obesity among older adults in Brazil

Singh, Ankur; Peres, Marco Aurélio; Peres, Karen Glazer; Bernardo, Carla de Oliveira; Xavier, Andre; D’Orsi, Eleonora

doi:10.1590/S0034-8910.2015049005590

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Sumário

Artigos Originais • Rev. Saúde Pública 49 • 2015 • https://doi.org/10.1590/S0034-8910.2015049005590 copy

Gender differences in the association between tooth loss and obesity among older adults in Brazil

Diferenças de gêneros na associação entre perda dentária e obesidade entre idosos brasileiros

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To analyze if differences according to gender exists in the association between tooth loss and obesity among older adults.

METHODS

We analyzed data on 1,704 older adults (60 years and over) from the baseline of a prospective cohort study conducted in Florianopolis, SC, Southern Brazil. Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders (age, gender, skin color, educational attainment, income, smoking, physical activity, use of dentures, hypertension, and diabetes). Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes. Interaction between gender and tooth loss was further assessed.

RESULTS

Overall mean body mass index was 28.0 kg/m². Mean waist circumference was 96.8 cm for males and 92.6 cm for females. Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders. Edentates had 1.4 (95%CI 1.1;1.9) times higher odds of being centrally obese than individuals with a higher number of teeth; however, the association lost significance after adjustment for confounders. In comparison with edentate males, edentate females presented a twofold higher adjusted prevalence of general and central obesity. In the joint effects model, edentate females had a 3.8 (95%CI 2.2;6.6) times higher odds to be centrally obese in comparison with males with more than 10 teeth present in both the arches. Similarly, females with less than 10 teeth in at least one arch had a 2.7 (95%CI 1.6;4.4) times higher odds ratio of having central obesity in comparison with males with more than 10 teeth present in both the arches.

CONCLUSIONS

Central obesity was more prevalent than general obesity among the older adults. We did not observe any association between general obesity and tooth loss. The association between central obesity and tooth loss depends on gender – females with tooth loss had greater probability of being obese.

Aged; Tooth Loss, epidemiology; Obesity, epidemiology; Gender and Health; Socioeconomic Factors; Risk Factors; Cross-Sectional Studies

Characteristic	n	%*	General obesity		Central obesity
Characteristic			%	95%CI	%	95%CI
Gender
Male	616	37.6	21.2	17.2;25.9	35.6	31.5;39.9
Female	1,088	62.4	37.1	34.3;39.9	65.3	61.6;68.8
Age years
60 to 64	470	28.0	32.4	27.8;37.5	50.7	45.9;55.5
65 to 69	384	23.1	33.6	27.3;40.6	53.9	47.4;60.3
70 to 74	340	19.5	31.9	26.5;37.8	59.1	51.9;65.9
75 to 79	272	15.8	26.2	20.7;32.4	53.0	46.5;59.4
≥ 80	238	13.6	28.7	22.6;35.7	55.8	47.9;63.3
Self-reported skin color
White	1,444	86.8	30.8	28.2;33.4	55.1	52.2;58.0
Parda	131	7.2	32.3	25.3;40.1	46.9	39.4;48.6
Black	84	4.3	28.7	17.7;43.1	41.3	28.6;55.3
Asian	12	0.7	19.7	4.2;58.0	13.7	1.8;57.5
Indigenous	17	1.0	35.2	15.3;62.0	71.0	42.9;88.9
Educational attainment (years of schooling)
≤ 4	745	40.6	34.6	30.6;38.8	57.3	52.1;62.4
5 to 8	321	18.5	28.3	23.0;34.3	50.6	44.4;56.7
9 to 11	234	15.9	29.3	23.4;36.0	48.4	40.4;56.4
> 12	393	25.0	28.6	23.3;34.5	55.5	49.3;62.5
Income
3^rd tertile	568	35.5	29.2	24.8;34.1	53.6	48.0;59.1
2^nd tertile	566	33.1	33.5	29.0;38.3	55.5	50.6;60.4
1^st tertile	571	31.4	30.6	26.3;35.4	53.4	48.7;58.0
Number of natural teeth
≥ 10 in both arches	395	26.8	29.1	22.9;36.2	49.8	42.5;57.0
< 10 in at least one arch	673	39.7	31.9	28.2;35.9	52.8	48.4;57.1
Edentate	582	33.5	32.0	28.2;36.1	58.6	53.4;63.6
Smoking
Never smoked	1,038	59.6	34.1	30.9;37.5	58.5	54.2;62.6
Former smoker	523	32.0	29.5	24.6;34.9	50.9	47.2;54.5
Current smoker	141	8.4	15.8	10.0;24.1	35.8	27.0;45.6
Physical activity in leisure time
Inactive	932	53.2	34.2	30.9;37.7	55.6	51.8;59.3
Insufficiently active	279	16.0	35.1	28.9;41.8	60.1	53.3;66.5
Active	494	30.8	23.6	19.6;28.2	48.6	42.4;54.9
Self-reported use of dental prosthesis
Yes	944	51.6	30.9	27.8;34.2	55.4	52.0;58.7
No	760	48.4	31.3	27.2;35.6	52.8	48.4;57.2
Hypertension
No	698	42.0	20.3	16.2;25.1	42.6	37.2;48.2
Yes	1,007	58.0	38.9	35.8;42.1	62.5	59.3;65.6
Diabetes
No	1,329	78.4	26.7	24.0;29.5	49.6	46.1;53.1
Yes	376	21.6	47.1	40.6;53.6	70.7	64.9;75.9
General obesity
Non-obese	1,179	68.9
Obese	525	31.1
Central obesity
Non-obese	799	45.9
Obese	905	54.1

Number of natural teeth	Model 1		Model 2		Model 3		Model 4		Model 5		Model 6		Model 7

	OR	95%CI	OR	95%CI	OR	95%CI	OR	95%CI	OR	95%CI	OR	95%CI	OR	95%CI
General
≥ 10 in both arches	1		1		1		1		1		1		1
< 10 in at least one arch	1.1	0.8,1.7	1.2	0.8,1.8	1.2	0.8,1.8	1.2	0.8,1.8	1.2	0.8,1.8	1.2	0.7,1.8	1.1	0.7,1.6
Edentate	1.2	0.8,1.7	1.3	0.9,1.9	1.1	0.7,1.8	1.2	0.8,1.8	1.2	0.7,1.9	1.1	0.6,1.9	1.0	0.6,1.7
Tooth loss*gender														p < 0.001
Males ≥ 10 teeth in both arches											1
Females ≥ 10 teeth in both arches											1.4	0.8,2.5
Males ≤ 10 teeth in at least one arch											1.0	0.5,1.9
Females ≤ 10 teeth in at least one arch											1.7	0.9,3.2
Edentate males											0.7	0.3,1.5
Edentate females											1.8	0.9,3.6
Central
≥ 10 in both arches	1		1		1		1		1		1		1
< 10 in at least one arch	1.1	0.8,1.6	1.1	0.8,1.7	1.1	0.8,1.7	1.2	0.8,1.6	1.2	0.8,1.8	1.2	0.7,1.8	1.0	0.7,1.5
Edentate	1.4	1.1,1.9	1.4	1.0,2.0	1.4	1.0,2.1	1.5	1.0,2.2	1.5	1.0,2.4	1.5	0.9,2.3	1.3	0.8,2.1
Tooth loss*gender														p < 0.001
Males ≥ 10 teeth in both arches											1
Females ≥ 10 teeth in both arches											2.1	1.3,3.4
Males ≤ 10 teeth in at least one arch											0.8	0.5,1.3
Females ≤ 10 teeth in at least one arch											2.7	1.6,4.4
Edentate males											0.8	0.5,1.5
Edentate females											3.8	2.2,6.6

Number of natural teeth	Model 1		Model 2		Model 3		Model 4		Model 5		Model 6		Model 7

	β Coefficient	95%CI	β Coefficient	95%CI	β Coefficient	95%CI	β Coefficient	95%CI	β Coefficient	95%CI	β Coefficient	95%CI	β Coefficient	95%CI
BMI
≥ 10 in both arches	Ref		Ref		Ref		Ref		Ref		Ref		Ref
< 10 in at least one arch	0.2	-0.6;1.0	0.5	-0.3;1.3	0.4	-0.5;1.2	0.4	-0.4;1.3	0.4	-0.4;1.2	0.3	-0.5;1.1	0.2	-0.6;0.9
Edentate	0.1	-0.6;0.9	0.6	-0.2;1.4	0.4	-0.4;1.2	0.5	-0.4;1.3	0.5	-0.4;1.3	0.2	-0.7;1.1	0.1	-0.8;0.9
WC
≥ 10 in both arches	Ref		Ref		Ref		Ref		Ref		Ref		Ref
< 10 in at least one arch	0.1	-1.9;2.1	0.4	-1.6;2.5	0.2	-1.8;2.2	0.1	-1.8;2.0	0.3	-1.6;2.0	0.0	-1.7;1.7	0.7	-1.0;2.5
Edentate	0.4	-1.9;2.6	1.1	-1.1;3.3	0.7	-1.6;2.9	0.4	-1.8;2.6	0.8	-1.5;3.3	0.5	-1.8;2.8	1.1	-1.1;3.3

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[1] Correspondence:Marco A Peres. Australian Research Centre for Population Oral Health. School of Dentistry. The University of Adelaide. 122 Frome Street, 1^st floor. Adelaide SA. Australia 5005. E-mail:marco.peres@adelaide.edu.au