School of Stomatology, Zunyi Medical University, Zunyi, Guizhou Province, 563000, China.
Guizhou University Medical College, Guiyang, Guizhou Province, 550025, China.
BMC Oral Health. 2024 Jul 21;24(1):825. doi: 10.1186/s12903-024-04599-7.
Red blood cell (RBC) folate is an indicator of long-term folate nutrition. Whether there is an association between RBC folate and periodontitis is unclear. This study aimed to use the NHANES database to determine whether RBC folate is associated with moderate/severe periodontitis.
A cross-sectional analysis of 10,151 participants in the NHANES database from 2009 to 2014 was performed. Multivariate logistic regression was used to analyze the independent relationship between RBC folate and moderate/severe periodontitis. The generalized additive model (GAM), restricted cubic splines (RCS), smooth curve fitting, and threshold effect analysis were used to explore the dose-response relationship and the potential nonlinear relationship between RBC folate and periodontitis. Finally, subgroup analysis and interaction tests were performed to determine the effect of covariates on the relationship between RBC folate and moderate/severe periodontitis.
After adjusting for all confounders, there was a negative association between RBC folate concentration and moderate/severe periodontitis. The lowest fraction Q1 (< 360 ng/mL) of RBC folate concentration was used as the reference group, multivariable-adjusted ORs and 95% CIs of the second (360-463 ng/mL), third (464-569 ng/mL), fourth (570-732 ng/mL), and the highest quintile (> 733 ng/mL) categories were 0.88 (0.77, 1.01), 0.83 (0.72, 0.96), 0.77 (0.67, 0.90), 0.65 (0.56, 0.77) respectively. Additionally, a threshold nonlinear association was found between RBC folate (ng/mL) log2 transformation and moderate/severe periodontitis.
This cross-sectional study revealed a negative relationship between RBC folate and moderate/severe periodontitis within a certain threshold range. Dentists and policymakers should pay closer attention to oral hygiene and health care for people with low or high RBC folate levels. Further causal and longitudinal research mechanisms are needed to validate our findings.
红细胞叶酸（RBC 叶酸）是长期叶酸营养状况的指标。RBC 叶酸与牙周炎之间是否存在关联尚不清楚。本研究旨在利用 NHANES 数据库确定 RBC 叶酸是否与中重度牙周炎有关。
对 2009 年至 2014 年 NHANES 数据库中的 10151 名参与者进行了横断面分析。采用多变量逻辑回归分析 RBC 叶酸与中重度牙周炎的独立关系。广义加性模型（GAM）、限制立方样条（RCS）、平滑曲线拟合和阈值效应分析用于探讨 RBC 叶酸与牙周炎之间的剂量反应关系和潜在非线性关系。最后进行亚组分析和交互检验，以确定协变量对 RBC 叶酸与中重度牙周炎之间关系的影响。
在调整了所有混杂因素后，RBC 叶酸浓度与中重度牙周炎呈负相关。最低分数 Q1（<360ng/mL）的 RBC 叶酸浓度作为参考组，多变量调整后的 OR 值和 95%CI 的第二（360-463ng/mL）、第三（464-569ng/mL）、第四（570-732ng/mL）和最高五分位数（>733ng/mL）分别为 0.88（0.77, 1.01）、0.83（0.72, 0.96）、0.77（0.67, 0.90）、0.65（0.56, 0.77）。此外，还发现 RBC 叶酸（ng/mL）对数转换与中重度牙周炎之间存在非线性关系。
本横断面研究显示，在一定阈值范围内，RBC 叶酸与中重度牙周炎呈负相关。牙医和政策制定者应更加关注低或高 RBC 叶酸水平人群的口腔卫生和保健。需要进一步的因果和纵向研究机制来验证我们的研究结果。
