Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose–response Association Study Based on NHANES 2009–2014

Abstract

The association between micronutrient intake and the risk of periodontitis has received much attention in recent years. However, most studies focused on the linear relationship between them. This study aimed to explore the dose–response association between micronutrient intake and periodontitis. A total of 8959 participants who underwent a periodontal examination, and reported their micronutrient intake levels were derived from the US National Health and Nutrition Examination Survey (NHANES, 2009–2014) database. Logistic regression was performed to evaluate associations between micronutrient intake and periodontitis after propensity score matching (PSM), and restricted cubic splines (RCS) analysis was conducted to explore the dose–response associations. Following PSM, 5530 participants were included in the RCS analysis. The risk of periodontitis was reduced with sufficient intake of the following micronutrients: vitamin A, vitamin B1, vitamin B2, and vitamin E. In addition, the risk of periodontitis was increased with excessive intake of the following micronutrients: vitamin B1 (1.8 mg/day, males; 1.3 mg/day, females), vitamin C (90 mg/day, males), and copper (1.1 mg/day, combined). In conclusion, a linear association was found between vitamin A, vitamin B2, vitamin C, and copper and periodontitis—namely, a sufficient intake of vitamin A and vitamin B2 might help reduce the prevalence of periodontitis; by contrast, a high intake of vitamin C and copper increased the risk. In addition, a nonlinear dose–response association was found for the incidence of periodontitis with vitamin B1 and vitamin E. When within reasonable limits, supplemental intake helped reduce the prevalence of periodontitis, while excessive intake did not help significantly and might even increase the risk. However, confounding factors, such as health awareness, should still be considered.

The protein-energy malnutrition is associated with the prevalence and mortality of periodontitis: a dose-response association study

“…A novel feature of this study is that we found a non-linear association between GNRI levels and the risk of periodontitis and mortality in patients with periodontitis. Our results also show for the rst time that PEM may be associated with a lower risk of periodontitis and a lower risk of death in patients with periodontitis, are consistent with those of previous studies on the association between nutritional intake and periodontitis [24][25][26][27][28].…”

“…We referred to the consensus recommendations of the CDC and the American Academy of Periodontology Prevention for epidemiological studies on the diagnosis of periodontitis [32]. In the present study, we assessed moderate and severe periodontitis as a category of periodontitis, with mild periodontitis and no periodontitis placed in another category to eliminate the potential risk of bias due to the possible overprevalence of mild periodontitis [27,33]. Moderate/severe periodontitis was de ned as follows:…”

“…The association between inadequate nutritional intake, represented by micronutrients, such as vitamins and minerals, and periodontitis has been widely investigated [24][25][26][27][28]. Periodontitis has been reported as a sensitive marker of de cient protein intake [29].…”

Associations of dietary antioxidant intake with periodontal health among US adults: An exploratory mediation analysis via mitochondrial function

“…Oxidative stress is a hallmark of periodontitis, and multiple antioxidant nutrients can potentially improve periodontal conditions by enhancing antioxidant defence and diminishing oxidative stress (Chapple & Matthews, 2007). Specifically, individuals with a low intake of vitamins A, C and E are at greater risk of developing periodontitis (Lee et al, 2017; Li, Shang, et al, 2022; Li, Song, & Chen, 2022). However, assessing the diet's overall antioxidant characteristics is challenging based on a single antioxidant.…”

Periodontitis and the risk of all‐cause and cause‐specific mortality among US adults with diabetes: A population‐based cohort study

“…Periodontitis is a common inflammatory disease that causes destruction of soft and hard periodontal tissues, leading to tooth mobility and loss (Li et al, 2021(Li et al, , 2022Pihlstrom et al, 2005). The disease is initiated by a dysbiotic microbial community, within which different microbial members or specific gene combinations have distinct roles that synergize to shape a disease-causing microbiota.…”