Background: We aimed to explore the association between periodontitis and lung function in the United States.
Methods: The data was based on the National Health and Nutrition Examination Survey (NHANES) 2009 to 2012. Periodontitis was defined following the CDC/AAP (Centers for Disease Control and Prevention/American Academy of periodontology) classification. Lung function measurements included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Linear regression and binary logistic regression were used to explore the association between periodontitis and lung function measurements. Restricted cubic spline was used to assess the dose-response relationships between the mean attachment loss (AL), the mean probing depth (PD) and spirometry-defined airflow obstruction (FEV1/FVC <0.7).
Results: A total of 6313 adults aged 30 years or older were included. Compared to those with non-periodontitis, the multivariate-adjusted odds ratios (ORs) of airflow obstruction for moderate and severe periodontitis were 1.38 (95% CI: 1.01 to 1.75) and 1.47 (95% CI: 1.06 to 2.01), the β coefficients of FEV1 for moderate and severe periodontitis were -130.16 (95% CI: -172.30 to -88.01) and -160.46 (95% CI: -249.94 to -70.97), the β coefficients of FVC for moderate and severe periodontitis were -100.96 (95% CI: -155.08 to -46.85) and -89.89 (95% CI: -178.45 to -1.33), the β coefficients of FEV1/FVC for moderate and severe periodontitis were -0.01 (95% CI: -0.02 to -0.01) and -0.02 (95% CI: -0.03 to -0.01). In stratified analyses, the multivariate-adjusted ORs of airflow obstruction for the moderate and severe periodontitis were 1.27 (95% CI: 0.84 to 1.93) and 2.31 (95% CI: 1.10 to 4.83) in former smokers, 1.84 (95% CI: 1.03 to 3.30) and 1.79 (95% CI: 1.02 to 3.16) in current smokers, with no significant association observed in never smokers. Mean clinical AL and mean PD were negatively associated with FEV1, FVC, and FEV1/FVC in never, former, and current smokers. Dose-response relationship analysis showed that the risk of airflow obstruction increased with increasing mean clinical AL and mean PD, and showed a non-linear dose-response relationship.
Conclusion: Our study suggested that moderate and severe periodontitis might be associated with the decline of lung function in the United States of America.
Keywords: periodontal-systemic disease interactions; periodontitis; public health; risk factor(s).
© 2021 American Academy of Periodontology.