Association between body roundness index and periodontitis: A cross-sectional study

Periodontitis, a prevalent chronic inflammatory disease, is associated with systemic inflammation and obesity. This study investigated whether the body roundness index (BRI), a measure of visceral adiposity, offers superior prediction of moderate-to-severe periodontitis compared to body mass index (BMI). We analyzed data from 10,297 adults participating in the National Health and Nutrition Examination Survey 2009 to 2014. Moderate-to-severe periodontitis was defined using established Centers for Disease Control and Prevention/American Academy of Pediatrics criteria, based on probing depth and clinical attachment loss. BRI was calculated using standardized anthropometric measurements. We analyzed the linear relationship between BRI and periodontitis using a weighted linear regression model and explored the nonlinear relationship between them using a weighted restricted cubic spline model. Interactions between BRI and BMI were evaluated. In addition, stratified analyses were performed according to BMI. A significant, nonlinear association was observed between BRI and moderate-to-severe periodontitis (P = .007). Compared to the lowest BRI quartile, the highest quartile exhibited an adjusted odds ratio of 1.571 (95% confidence intervals: 1.022-2.413) for periodontitis. A significant BRI-BMI interaction (P < .05) revealed this association was most pronounced and nonlinear in obese individuals (BMI ≥ 30). BRI demonstrates a significant, nonlinear association with moderate-to-severe periodontitis, particularly pronounced in obese individuals. BRI may refine periodontal risk stratification by considering body fat distribution beyond overall adiposity. Further longitudinal validation of these findings is warranted.