Background: Generalized severe periodontitis (GSP), a common oral inflammatory disease associated with systemic circulatory disease, can result in tooth loss and chewing dysfunction. Objective: This study aims to investigate the relationship between GSP and systemic circulation-related hematological parameters in young adults aged 30 to 40.Methods: A total of 212 participants were enrolled in the National Health and Nutrition Examination Surveys (NHANES) during 2009 to 2014. The generalized severe periodontitis was identified as 30% of teeth with ≥ 5mm attachment loss. Restricted cubic splines were used to investigate the nonlinearity among variables. Logistic regression analysis was utilized to study the hematological parameters correlated with GSP. Stepwise regression and receiver operating characteristic curve were applied to generate and assess the predictive models for GSP occurrence. Results: Based on the indicators of 212 subjects, we found that generalized severe periodontitis tended to occur in males and was accompanied by higher Hemoglobin (HB), Hematocrit (HCT), Red cell distribution width (RDW), Red blood cell count (RBC), as well as less Poverty-income ratio (PIR). Restricted cubic splines confirmed the relationships between GSP and HB or HCT were nonlinear. Logistic regression showed that RDW was a potential indicator of GSP. Compared with HCT (AUC = 0.702), HB (AUC = 0.697), RBC (AUC = 0.684), RDW (AUC = 0.585), and other single variable, multi-variables regression (including gender, PIR, RDW, education levels, and BMI) (AUC = 0.913) demonstrated better predictive effects on generalized severe periodontitis.Conclusion: Hematological parameters can predict generalized severe periodontitis, for which RDW is a potential indicator.
Background Periodontitis-related attachment loss is accompanied by mucosal bleeding and inflammatory lesions. Dietary vitamin K and fibre intake are known to be correlation factors of haemostasis and anti-inflammation, respectively. Objective To explore the association between severe periodontal attachment loss and vitamin K or fibre intake in American adults. Methods A cross-sectional analysis was conducted including 2747 males and 2218 females in the National Health and Nutrition Examination Surveys (NHANES) from 2009 to 2014. The number of teeth with severe periodontal attachment loss (above 5 mm attachment loss) was used as the dependent variable. The main independent variables included the intake of vitamin K and dietary fibre. The association among variables was examined using multivariable linear regression models, hierarchical regression, fitted smoothing curves, and generalized additive models. Results Based on the indicators of 4965 subjects, we found that severe attachment loss tended to occur in elderly individuals or males and was accompanied by less intake of vitamin K or dietary fibre, as well as lower educational qualification. Vitamin K intake was stably negatively associated with attachment loss progression in each multivariable linear regression model. In subgroup analyses, a negative association between fibre intake and attachment loss progression was identified in all races except blacks (β = 0.0005, 95% CI: -0.0005 to 0.0016). The relationship between fibre intake and attachment loss progression was a broad U-shaped curve (inflection point: 753.4 mg), which especially manifested in males (inflection point: 967.5 mg). Conclusion There was an inverse association between vitamin K intake and the progression of periodontal attachment loss in American adults, while dietary fibre should be moderate in intake (below 753.4 mg), especially in males (below 967.5 mg).
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