To investigate whether E-DII or vitamin D mediates the relationship between oral health and cardiovascular disease (CVD) risk.
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.
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.
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.
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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This work was supported by the National Natural Science Foundation of China (No.81973129).
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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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