ObjectiveWe aimed to explore the association between periodontitis and abdominal aortic calcification (AAC) among a nationally representative sample of US adults.DesignCross- sectional study.SettingThe National Health and Nutrition Examination Survey (2013–2014).ParticipantsA total of 2149 participants aged 40 years or older who have complete information for periodontitis and AAC assessment test were included in this study.Primary and secondary outcome measuresAAC scores can be accurately identified on lateral spine images obtained by dual-energy X-ray absorptiometry, and both the AAC-24 and AAC-8 semiquantitative scoring tools were used for AAC evaluation. Linear regression analysis was used to investigate the relationship between periodontitis and the AAC-8 and AAC-24 scores. Multivariate logistic regression models and reported ORs were used to examine the relationship between periodontitis and AAC.ResultsThe prevalence of severe periodontitis combined with severe AAC was 8.49%–8.54%. According to the AAC-8 and AAC-24 score classifications, patients with severe periodontitis had higher odds of severe AAC (AAC-8 score ≥3: (OR: 2.53; 95% CI 1.04 to 6.17) and AAC-24 score >6: (OR: 3.60; 95% CI 1.48 to 8.78)). A positive association between mild–moderate periodontitis and severe AAC was found only when the AAC-24 score was applied (OR: 2.25; 95% CI 1.24 to 4.06). In the subgroup analyses, the likelihood ratio test showed no multiplicative interaction (all p value for interaction >0.05).ConclusionsThe findings showed that periodontitis is associated with an increased risk of severe AAC in the US population aged 40 years and older; this requires further large-scale prospective studies for confirmation.
ObjectiveTo investigate the association between red cell distribution width (RDW) and the RDW to platelet count ratio (RPR) and cardiovascular diseases (CVDs) and to further investigate whether the association involves population differences and dose–response relationships.DesignCross-sectional population-based study.SettingThe National Health and Nutrition Examination Survey (1999–2020).ParticipantsA total of 48 283 participants aged 20 years or older (CVD, n=4593; non-CVD, n=43 690) were included in this study.Primary and secondary outcome measuresThe primary outcome was the presence of CVD, while the secondary outcome was the presence of specific CVDs. Multivariable logistic regression analysis was performed to determine the relationship between RDW or the RPR and CVD. Subgroup analyses were performed to test the interactions between demographics variables and their associations with disease prevalence.ResultsA logistic regression model was fully adjusted for potential confounders; the ORs with 95% CIs for CVD across the second to fourth quartiles were 1.03 (0.91 to 1.18), 1.19 (1.04 to 1.37) and 1.49 (1.29 to 1.72) for RDW (p for trend <0.0001) compared with the lowest quartile. The ORs with 95% CIs for CVD across the second to fourth quartiles were 1.04 (0.92 to 1.17), 1.22 (1.05 to 1.42) and 1.64 (1.43 to 1.87) for the RPR compared with the lowest quartile (p for trend <0.0001). The association of RDW with CVD prevalence was more pronounced in females and smokers (all p for interaction <0.05). The association of the RPR with CVD prevalence was more pronounced in the group younger than 60 years (p for interaction=0.022). The restricted cubic spline also suggested a linear association between RDW and CVD and a non-linear association between the RPR and CVD (p for non-linear <0.05).ConclusionThere are statistical heterogeneities in the association between RWD, RPR distributions and the CVD prevalence, across sex, smoking status and age groups.
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