The association between periodontitis and dyslipidemia according to smoking and harmful alcohol use in a representative sample of Korean adults

Clin Oral Investig. 2020 Feb;24(2):937-944. doi: 10.1007/s00784-019-02989-8. Epub 2019 Jul 2.

Abstract

Objectives: The aim of this study was to examine whether dyslipidemia is associated with periodontitis according to age, sex, smoking, and harmful alcohol use in a representative sample of Korean adults who participated in the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-3).

Materials and methods: We examined 3987 subjects aged 19 to 79 years who participated in the KNHANES VI-3. Dyslipidemia was defined according to the definition proposed by the Korean Society of Lipidology and Atherosclerosis. The periodontal status of the patients was assessed using the community periodontal index. Multivariate logistic regression analysis was carried out and adjusted for sociodemographic variables, oral and general health behaviors, and oral health status. All analyses considered a complex sampling design, and multivariate analysis was performed in the age, sex, smoking, and harmful alcohol use subgroups.

Results: Multivariate logistic regression analysis revealed significant associations between periodontitis and dyslipidemia including hypertriglyceridemia and hypo-high-density lipoprotein (HDL) cholesterolemia. In the subgroup analysis, periodontitis was significantly associated with hypo-HDL cholesterolemia in subjects older than 40 years, males, heavy smokers, and hazardous and harmful alcohol users. Moreover, periodontitis was significantly associated with hypercholesterolemia in hazardous and harmful alcohol users.

Conclusions: The prevalence of periodontitis (CPI 3, 20.7%; CPI 4, 9.0%) was 29.7% in Korea. Hyper-TG and hypo-HDL-C were associated with periodontitis in all subjects. In the subgroup analysis, the association of periodontitis with hyper-TC and pre-hyper-TC was further confirmed in harmful alcohol users and males, respectively.

Clinical relevance: This study reaffirmed that periodontitis is associated with dyslipidemia, especially with hyper-TG and hypo-HDL-C. As the association of periodontitis with hypo-HDL-C, hyper-TC, and pre-hyper-TC was found differently in subgroups according to age, gender, smoking, and alcohol drinking, researchers need to consider effect modifiers in further studies on the association between periodontitis and dyslipidemia.

Keywords: Association; Dyslipidemia; Korea National Health and Nutrition Examination Survey (KNHANES); Periodontal disease; Relationship.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Dyslipidemias*
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Periodontitis*
  • Republic of Korea
  • Risk Factors
  • Smoking
  • Young Adult