Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
Clin Oral Investig. 2023 Aug;27(8):4727-4733. doi: 10.1007/s00784-023-05100-4. Epub 2023 Jun 8.
Periodontitis is accompanied by attachment loss and alveolar bone resorption. Vitamin D (VD) deficiency was closely associated with bone loss or osteoporosis. The study aims to investigate the potential relationship between different VD levels and severe periodontal attachment loss in American adults.
A cross-sectional analysis was conducted including 5749 participants in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014. The association of periodontal attachment loss progression with total VD, vitamin D3 (VD3), and vitamin D2 (VD2) levels was assessed using multivariable linear regression models, hierarchical regression, fitted smoothing curves, and generalized additive models.
Based on the indicators of 5749 subjects, we found that severe attachment loss tended to occur in the elderly or males and was accompanied by less total VD levels, or VD3 levels, as well as a lower poverty-income ratio (PIR). Total VD (below the inflection point: 111 nmol/L) or VD3 were negatively associated with the progression of attachment loss in each multivariable regression model. In threshold analysis, VD3 is linearly correlated with the progression of attachment loss (β = - 0.0183, 95% CI: - 0.0230 to - 0.0136). The relationship between VD2 and attachment loss progression was an S-shaped curve (inflection point: 5.07 nmol/L).
Increasing total VD (below 111 nmol/L) and VD3 levels may be beneficial to periodontal health. VD2 levels above 5.07 nmol/L were a risk factor for severe periodontitis.
The present study reports that different vitamin D levels may serve as different associations with periodontal attachment loss progression.
牙周炎伴有附着丧失和牙槽骨吸收。维生素 D（VD）缺乏与骨丢失或骨质疏松密切相关。本研究旨在探讨美国成年人不同 VD 水平与严重牙周附着丧失之间的潜在关系。
对 2009 年至 2014 年期间参加国家健康和营养调查（NHANES）的 5749 名参与者进行了横断面分析。使用多变量线性回归模型、层次回归、拟合平滑曲线和广义加性模型评估牙周附着丧失进展与总 VD、维生素 D3（VD3）和维生素 D2（VD2）水平的关系。
根据 5749 名受试者的指标，我们发现严重附着丧失倾向于发生在老年人或男性中，且伴有总 VD 水平较低或 VD3 水平较低，以及较低的贫困收入比（PIR）。总 VD（低于拐点：111 nmol/L）或 VD3 与每个多变量回归模型中的附着丧失进展呈负相关。在阈值分析中，VD3 与附着丧失的进展呈线性相关（β=-0.0183，95%CI：-0.0230 至-0.0136）。VD2 与附着丧失进展之间的关系呈 S 形曲线（拐点：5.07 nmol/L）。
增加总 VD（低于 111 nmol/L）和 VD3 水平可能有益于牙周健康。VD2 水平高于 5.07 nmol/L 是严重牙周炎的危险因素。
本研究报告不同的维生素 D 水平可能与牙周附着丧失的进展有不同的关联。
