Guo Jia-Jie, Hang Qi-Qi, Xu Ting, Liang Wei-Xuan, Gao Jia-Kun, Ou Hong-Biao, Jiang Fu-Zhen, Qiu Xi-Chen-Hui, Tian Zu-Zhang, Zhang Yu-Zhong, Zhang Jing
The Second School of Clinical Medicine, Guangzhou Medical University, Guangzhou, 511436, China.
The Second School of Clinical Medicine, Nanjing Medical University, Nanjing, 211166, China.
Lipids Health Dis. 2025 Jun 3;24(1):199. doi: 10.1186/s12944-025-02619-1.
Periodontitis, a chronic inflammatory disease, is closely linked to cardiovascular health. While Life's Essential 8 (LE8) evaluates cardiovascular metrics, recent recommendations suggest incorporating psychological health (PHQ-9) to form Life's Crucial 9 (LC9). However, evidence regarding the utility of LC9 in periodontal disease remains limited.
We analyzed data from 7,674 adults in the 2009-2014 NHANES cycles. LC9 scores were calculated by integrating LE8 and PHQ-9 metrics, then categorized into quartiles. The association between LC9 and periodontitis was examined using weighted logistic regression, restricted cubic spline (RCS), subgroup and WQS analyses. Mediation analysis assessed the roles of central adiposity (ABSI, WWI) and systemic inflammation (SII, SIRI).
Higher LC9 scores were associated with lower periodontitis prevalence (29.4% in highest vs. 52.1% in lowest quartile; P < 0.001), with a 15.5% risk reduction per 10-unit increase (OR = 0.845; 95% CI: 0.795-0.897). WQS analysis identified nicotine exposure, sleep health, blood glucose, blood pressure, and depressive symptoms as key contributors. Mediation analysis showed partial effects through WWI (21.617%), ABSI (10.869%), SIRI (7.120%), and SII (5.351%). LC9 did not significantly outperform LE8 in prediction.
Higher LC9 score is linked to reduced periodontitis prevalence and severity, with central adiposity and systemic inflammation partially mediating this relationship. These findings emphasize comprehensive cardiovascular health management may help reduce periodontal disease risk.
牙周炎是一种慢性炎症性疾病，与心血管健康密切相关。虽然生命基本八项（LE8）评估心血管指标，但最近的建议提出纳入心理健康指标（PHQ-9）以形成生命关键九项（LC9）。然而，关于LC9在牙周疾病中的效用的证据仍然有限。
我们分析了2009 - 2014年美国国家健康与营养检查调查（NHANES）周期中7674名成年人的数据。通过整合LE8和PHQ-9指标计算LC9得分，然后将其分为四分位数。使用加权逻辑回归、受限立方样条（RCS）、亚组分析和加权分位数和（WQS）分析来研究LC9与牙周炎之间的关联。中介分析评估了中心性肥胖（ABSI、WWI）和全身炎症（SII、SIRI）的作用。
较高的LC9得分与较低的牙周炎患病率相关（最高四分位数为29.4%，最低四分位数为52.1%；P < 0.001），每增加10分风险降低15.5%（OR = 0.845；95% CI：0.795 - 0.897）。WQS分析确定尼古丁暴露、睡眠健康、血糖、血压和抑郁症状为关键因素。中介分析显示通过WWI（21.617%）、ABSI（10.869%）、SIRI（7.120%）和SII（5.351%）产生部分影响。LC9在预测方面并未显著优于LE8。
较高的LC9得分与牙周炎患病率和严重程度降低相关，中心性肥胖和全身炎症部分介导了这种关系。这些发现强调全面的心血管健康管理可能有助于降低牙周疾病风险。
