Interaction Between Tobacco Smoke Exposure and Zinc Intake and Its Effect on Periodontitis: Evidence From NHANES

Abstract

Aim: Tobacco smoke exposure, zinc intake with periodontitis were closely related. This study was to assess the relationship of coexistence of tobacco smoke exposure and zinc intake on the periodontitis. Materials and methods: This cross-sectional study included 9,364 participants from National Health and Nutrition Examination Survey. Using weighted multivariate logistic regression model to investigate the independent relationship and interaction effect between tobacco smoke exposure, zinc intake and periodontitis. Odds ratio (OR) with 95% confidence interval (CI) were calculated. The additive interaction was evaluated using relative excess risk due to interaction (RERI), attributable proportion of interaction (AP) and synergy index (SI). Results: 56.57% participants had periodontitis. Compared with participants without tobacco smoke exposure, those with tobacco smoke exposure had an increased odd of periodontitis (OR=1.96, 95%CI: 1.67-2.31). Similarly, the patients with adequate zinc intake were found to have a decreased odds of periodontitis than those inadequate zinc intake (OR=0.86, 95%CI: 0.76-0.98). Importantly, there was antagonistic interaction between zinc intake and tobacco smoke exposure on periodontitis [RERI (95% CI): -0.432 (-0.829, -0.034), AP (95% CI): -0.242 (-0.470, -0.014), SI (95%CI): 0.645 (0.446-0.932)]. Conclusion: This analysis may provide evidence for the antagonistic interaction between tobacco smoke exposure and zinc intake on the periodontitis development.