# Obesity and cathepsin S in periodontal health and disease: A prospective clinical observational study

## TL;DR

This study shows that obesity is linked to higher levels of cathepsin S in the mouth, which may worsen periodontal disease and reduce treatment effectiveness.

## Contribution

The study identifies cathepsin S as a potential biomarker linking obesity to periodontitis and treatment outcomes.

## Key findings

- Obese individuals with periodontitis had the highest cathepsin S levels in gingival crevicular fluid and saliva.
- Nonobese individuals showed greater improvement in periodontal health after treatment compared to obese individuals.
- Cathepsin S levels correlated with clinical periodontal parameters and body mass index.

## Abstract

This study aimed to evaluate the association between obesity, periodontal status, and cathepsin S (CatS) levels in gingival crevicular fluid (GCF) and saliva and assess the impact of obesity on clinical and biochemical outcomes following nonsurgical periodontal therapy (NSPT).

A total of 52 participants were categorized into nonobese with periodontal health, obese with periodontal health, nonobese with periodontitis, and obese with periodontitis groups. Clinical, periodontal, and anthropometric measurements were recorded. CatS levels in GCF and saliva were quantified using an enzyme-linked immunosorbent assay. NSPT was performed in the periodontitis groups, and clinical and biochemical parameters were re-evaluated after 3 months.

GCF and salivary CatS levels were highest in the obese periodontitis group and lowest in the nonobese periodontal health group (p < 0.001). Regression analysis revealed a significant positive association between body mass index (BMI), GCF, salivary CatS levels, and plaque index (p < 0.05). Significant positive correlations were observed between BMI and CatS levels, as well as between CatS levels and clinical periodontal parameters (p < 0.001). Following NSPT, both periodontitis groups exhibited significant clinical and biochemical improvement (p < 0.05). However, reductions in bleeding on probing, probing pocket depth, clinical attachment loss, and salivary CatS levels were significantly greater in the nonobese periodontitis group than in the obese group (p < 0.001).

Periodontitis and obesity are associated with elevated CatS levels in GCF and saliva. Obesity may negatively impact clinical responses to NSPT. CatS could serve as a potential biomarker linking obesity to periodontitis and NSPT outcomes.