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Oral health and 10-year cardiovascular risk in US adults: mediating role of inflammatory diet and vitamin D

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Abstract

Objective

To investigate whether E-DII or vitamin D mediates the relationship between oral health and cardiovascular disease (CVD) risk.

Methods

This study involved 6616 participants aged over 30 years old from the National Health and Nutrition Examination Survey (NHANES) in 2009–2014. Dietary inflammation and 10-year CVD risk were evaluated via the Energy-adjusted Dietary Inflammatory Index (E-DII) and the Framingham Risk Score (FRS), respectively. We used correlation analysis and mediation analysis to investigate the role of dietary inflammation and vitamin D in the relationship between oral health and CVD risk.

Results

Oral health indicators and CVD risk were positively correlated with E-DII (r > 0, P < 0.001) and negatively correlated with vitamin D levels (r < 0, P < 0.001). The estimated mediating role of E-DII and vitamin D in the overall association between oral health and 10-year risk of CVD ranged from 4.9 to 7.5% and 6.6 to 11.6%, respectively. Furthermore, the mediation proportion of E-DII and vitamin D levels in the total association between oral health indicators and FRS were increased in participants without periodontitis.

Conclusion

Both E-DII and serum vitamin D were mediated the association between oral problems and 10-year CVD risk, especially in participants without periodontitis. Among them, E-DII played a positive mediating role, and serum vitamin D levels was a negative mediator.

Clinical relevance

Anti-inflammatory diet and prevention of vitamin D deficiency might reduce the impact of oral problems on cardiovascular disease risk to some extent. The study highlights the important role of oral health and dietary inflammation and vitamin D in primary prevention of cardiovascular disease.

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Data availability

All data extracted in this study are included in this article.

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Funding

This work was supported by the National Natural Science Foundation of China (No.81973129).

Author information

Author notes

  1. Ling Wang and Xuanzhi Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People’s Republic of China

    Ling Wang, Mengzi Sun, Xuhan Wang, Xiaotong Li, Wenyu Hu, Yixue Yang, Jing Li, Yibo Dong & Bo Li

  2. Department of Clinical Laboratory Diagnosis, College of Medical Technology, Beihua University, Jilin, 132013, People’s Republic of China

    Xuanzhi Wang

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  1. Ling Wang
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Contributions

Bo Li and Ling Wang made the study design; Ling Wang, Xuanzhi Wang, Mengzi Sun conducted the study; Ling Wang and Mengzi Sun analyzed the data and wrote the manuscript; Xuanzhi Wang, Mengzi Sun, Xuhan Wang, Xiaotong Li, Wenyu Hu, Yixue Yang, Jing Li and Yibo Dong participated amending the manuscript. All authors agreed with the final version of the manuscript. Bo Li are the guarantors.

Corresponding author

Correspondence to Bo Li.

Ethics declarations

Ethics approval and consent to participate

The protocols of NHANES were approved by the institutional review board of the National Center for Health Statistics, CDC. Written informed consent was obtained from each participant before participation in this study.

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All authors have seen and approved the final version of the manuscript being submitted. This work was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part.

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The authors declare no competing interests.

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Wang, L., Wang, X., Sun, M. et al. Oral health and 10-year cardiovascular risk in US adults: mediating role of inflammatory diet and vitamin D. Clin Oral Invest 27, 3405–3413 (2023). https://doi.org/10.1007/s00784-023-05097-w

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  • DOI: https://doi.org/10.1007/s00784-023-05097-w

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