Association Between `Life's Essential 8` and Periodontitis: A Cross-Sectional Study From the NHANES Database

Abstract

BackgroundPeriodontitis as a chronic inflammatory disease, and its persistent inflammatory state can lead to the cardiovascular system damage. Studies have shown that life's essential 8 (LE8), as an indicator of cardiovascular health, was associated with the risk of several inflammatory diseases. This study aimed to assess the association between LE8 and its subscales and the risk of periodontitis. MethodsData of participants who accepted the periodontitis examinations were extracted from the National Health and Nutrition Examination Surveys (NHANES) database (2009-2014). LE8 contains four health behaviors (diet, physical activity, nicotine exposure, sleep health) and four health factors (BMI, blood lipids, blood glucose and blood pressure) and was categorized into low (0-49), moderate (50-79), and high (80-100) level. Covariates included demographic information, laboratory values, diseases history and medications history. The weighted univariate and multivariate logistic regression models were performed to assess the association between LE8 and periodontitis, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on different age, gender and cardiovascular disease (CVD) history were further assessed the association. ResultsTotal 5,106 adults were included, of whom 2,606 (51.04%) had periodontitis. After adjustment for age, gender, race, PIR, education level, marital status, drinking, CVD, nonsteroidal anti-inflammatory agents, waist circumference (WC), vitamin D (VD) and dental floss/device, high LE8 score (OR=0.48, 95%CI: 0.32-0.73), higher health behaviors score (OR=0.56, 95%CI: 0.42-0.73) and higher health factors score (OR=0.71, 95%CI: 0.51-0.99) were associated with the lower occurrence of periodontitis, especially in adults with male, aged <60 years and without CVD history. Moreover, the occurrence of periodontitis was decreased when score of total LE8, health factors and health behaviors increased every 10 scores. ConclusionLE8 score and its subscales scores were associated with the lower odds of periodontitis. Promoting adherence to high cardiovascular health levels may be beneficial to reduce the burden of periodontitis.