Association between Caries, Obesity and Insulin Resistance in Mexican Adolescents

Aim: To determine the association among dental caries, obesity and insulin resistance in Mexican adolescents.Methods: Body Mass Index, obesity (OB) blood pressure, insulin level, insulin resistance (IR), triglycerides level, serum HDL-cholesterol (cHDL), DMFT index and salivary flow were measured. Results:Anthropometric measures showed a significant statistical difference (p < 0.05). Insulin level was 8.98 for healthy subjects, whereas for OB-IR group was 25.35, there was a statistical significant difference (p <0.05). Triglycerides level was 88.50 for healthy subjects and 169.40 mg/dL for OB-IR; cHDL was 52.88 for healthy and 41.82 mg/dL for OB-IR group, both showed a statistically significant difference (p < 0.05). Salivary flow was 4.30 for healthy and for OB-IR group was 5.48 ml/min showed a significant statistical difference(p < 0.05). DMFT index was 3.02 for healthy and for OB-IR adolescents was 4.78, showed a significant statistical difference (p < 0.05). The caries component of DMFT index was 1.84 for healthy and was 3.52 for OB-IR adolescents, showed a significant statistical difference (p < 0.05). According to the multivariate analysis, DMFT (OR=3.10; IC95%=0.20-1.02, p=0.042) and decay (OR=3.30; IC95%=0.19-1.0,p=0.011) were associated with subjects with OB-IR. Conlusion: OB-IR Mexican adolescents showed a positive association with DMFT.

caries, obesity, insulin resistance, children, Mexico

1. Palmer CA. Dental caries and obesity in children: different problems, related causes. Quintessence Int, 36: 457–461, 2005

2. Irigoyen ME, Luengas IF, Yashine A, Mejia AM, Maupome G. Dental caries experience in Mexican schoolchildren from rural and urban com-munities. Int Dent J, 50: 41–45, 2000.

3. Elías Boneta AR, Crespo Kebler K, Gierbolini CC, Toro Vizcarrondo CE, Psoter WJ. Dental Caries Prevalence of twelve year olds in Puerto Rico. Community Dent Health,  20: 171–176, 2003.

4. Tinanoff N. Association of diet with caries in preschool children. Dent Clin North Am, 49: 725–737, 2005.

5. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA, 303: 242–249, 2010.

6. National Center for Health Statistics. Health, United States, 2004 with Chartbook  on  Trends  in  the  Health  of  Americans.  Hyattsville,  MD; 2004. http://www.cdc.gov/nchs/data/hus/hus04trend.pdf#070

7. National Health and Nutrition Survey (NHANES Survey 2003-2006). http://www.cdc.gov/obesity/childhood/prevalence.html 

8. Encuesta  Nacional  de  Salud  y  Nutrición-ENSANUT  2006. http://www.insp.mx/ensanut/resultados_ensanut.pdf.

9. Le Roith D, Zick Y. Recent advance in our understanding of insulin action and insulin resistance. Diabetes Care, 24: 588–597, 2001.

10. Federación  Mexicana  de  Diabetes,  A.C.  http://www.fmdiabetes.org/v2/paginas/d_numeros.php.

11. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insdulin resistance and type diabetes. Nature, 444: 840–846, 2006

12. Vazquez-Nava F, Vazquez-Rodriguez EM, Saldivar-Gonzalez AH, Li-Ochoa  D,  Martinez-Perales  GM,  Joffre-Velazquez  VM.  Association between obesity and dental caries in a group of preschool children in Mexico. J Public Health Dent, 70: 124–130, 2010.

13. Hilgers KK, Kinane DE, Scheetz JP.  Association between childhood obesity  and  smooth-surface  caries  in  posterior  teeth:  a  preliminary study. Pediatr Dent, 28: 23–28, 2006.

14. Kantovitz  KR,  Pascon  FM,  Rontani  RM,  Gaviao  MB.  Obesity  and Dental Caries. A systematic review. Oral Health Prev Dent, 4: 137–144, 2006. 

15. Macek MD, Mitola DJ. Exploring the association between overweight and dental caries among US children. Pediatr Dent, 28: 375–380, 2006.

16. Moreira PV, Rosenblatt A, Severo AM. Prevalence of dental caries in obese and normal-weight Brazilian adolescents attending state and pri-vate schools. Community Dent Health,  23: 251–253, 2006.

17. Alm A, Fahraeus C, Wendt LK, Koch G, Andersson-Gare B, Birkhed

D.  Body  adiposity  status  in  teenagers  and  snacking  habits  in  early childhood in relation to approximal caries at 15 years of age. Int J Pae-diatr Dent, 18: 189–196, 2008.

18. Matthews  DR,  Hosker  JP,  Rudenski  AS,  Naylor  BA,  Treacher  DF, Turner  RC.  Homeostasis  model  assessment:  insulin  resistance  and beta-cell function from fasting plasma glucose and insulin concentra-tions in man. Diabetologia, 28: 412–419, 1985.

19. Pinhas-Hamiel O, Lerner-Geva L, Copperman N, Jacobson MS. Insulin resistance and parenteral obesity as predictors to response to therapeu-tic life style change in obese children and adolescents 10-18 years old. J Adolesc Health, 43: 437–443, 2008.

20. Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL. Preva-lence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other refe-rence  values  for  body  mass  index. Am  J  Clin  Nutr,  73:  1086–1093, 2001.

21. Loyola-Rodriguez  JP,  Martinez-Martinez  RE,  Flores-Ferreyra  BI, Patiño-Marin N, Alpuche-Solis AG, Reyes-Macias JF. Distribution of Streptococcus mutans and Streptococcus sobrinus in saliva of Mexican caries-free  and  caries-active  children  by  microbial  and  molecular (PCR) assays. J Clin Pediatr Dent, 32: 121–126, 2008.

22. Halley Castillo E, Borges G, Talavera JO, Orozco R, Vargas-Aleman C, Huitron-Bravo  G,  Diaz-Montiel  JC,  Castañon  S,  Salmeron  J.  Body mass index and the prevalence of metabolic syndrome among children and  adolescents  in  two  Mexican  populations.  J Adolesc  Health,  40: 521–526, 2007.

23. Weiss  R,  Dziura  J,  Burgert TS, Tamborlane WV, Taksali  SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S. Obesity and the metabolic syndrome in children and adolescents. New Engl J Med, 350: 2362–2374, 2004.

24. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. J Am Med Assoc, 295: 1549–1555, 2006.

25. Burrows AR,  Leiva  BL,  Weistaub  G,  Ceballos  SX,  Gattas  ZV,  Lera ML, Albala BC. Prevalence of metabolic syndrome in a sample of chil-dren  consulting  in  an  obesity  clinic.  Rev  Med  Child,  135:  174–181, 2007. 

26. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shibai GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab, 89:108–113, 2004.

27. Garcia-Cortes JO, Medina-Solis CE, Loyola-Rodriguez JP, Mejia-Cruz JA,  Medina-Cerda  E,  Patiño-Marin  N,  Pontigo-Loyola  AP.  Dental caries’ experience, prevalence and severity in Mexican adolescents and young adults. Rev Salud Publica, 11: 82–91, 2009.

28. Modeer T, Blomberg CC, Wondimu B, Julihn A, Marcus C. Association between obesity, flow rate of whole saliva, and dental caries in adoles-cents. Obesity 18: 2367–2673, 2010.

29. Humprey SP, Williamson RT. A Review of Saliva: normal composition, flow and function. J Prosth Dent, 85: 162–169, 2001.

30. Fenoll-Palomares C, Muñoz Montagud JV, Sanchiz V, Herreros B, Her-nandez V, Minguez M, Benages A.  Unstimulated salivary flow rate, pH and  buffer  capacity  of  saliva  in  healthy  volunteers.  Rev  Esp  Enferm Dig, 96: 773–783, 2004.