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Associations between vitamin D levels and periodontal attachment loss

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Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusion

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.

Clinical relevance

The present study reports that different vitamin D levels may serve as different associations with periodontal attachment loss progression.

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Data availability

Publicly available datasets were analyzed in this study. Data used for this study are available on the NHANES website: https://wwwn.cdc.gov/nchs/nhanes/.

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Acknowledgements

The authors thank the CDC for collecting the publicly available NHANES database.

Funding

This work was supported by the Basic and Clinical Cooperative Research Promotion Program of Anhui Medical University (2021xkjT038), the 2022 Disciplinary Construction Project in the School of Dentistry, Anhui Medical University (2022xkfyhz09), and the National Natural Science Foundation of China (82201026).

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Authors and Affiliations

  1. Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China

    Xiaoyun Liu, Bichong Dai, Yuanyuan Chuai, Menglin Hu & Hengguo Zhang

  2. Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China

    Hengguo Zhang

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Contributions

All authors have made substantial contributions to the conception and design of the study. Xiaoyun Liu collected the data, wrote the manuscript, and revised it critically. Bichong Dai and Menglin Hu assisted Yuanyuan Chuai with data analyses and data interpretation. Hengguo Zhang was involved in designing the study and revising the manuscript critically. All authors read and approved the final manuscript.

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Correspondence to Hengguo Zhang.

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The studies involving human participants were approved by the institutional review board of the National Center for Health Statistics, CDC, and were conducted in accordance with the Helsinki Declaration of 1975, as revised in 2013. The patients/participants provided their written informed consent to participate in this study.

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Xiaoyun Liu, Bichong Dai, and Yuanyuan Chuai are the co-first authors of this article.

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Liu, X., Dai, B., Chuai, Y. et al. Associations between vitamin D levels and periodontal attachment loss. Clin Oral Invest 27, 4727–4733 (2023). https://doi.org/10.1007/s00784-023-05100-4

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