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Development and validation of a predictive model for periodontitis using NHANES 2011-2012 data.

ABSTRACT: AIM:To develop and validate a predictive model for moderate-to-severe periodontitis in the adult USA population, with data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) cycle. MATERIAL AND METHODS:A subset of 3017 subjects aged >30 years, with >14 teeth present and having received a periodontal examination in addition to data collected on cardio-metabolic risk measures (smoking habit, body mass index [BMI], blood pressure, total cholesterol and glycated haemoglobin [HbA1c]) were used for model development by multivariable logistic regression. RESULTS:The prevalence of moderate and severe periodontitis using CDC/AAP classification was 37.1% and 13.2%, respectively. A multivariable logistic regression model revealed that HbA1c ?5.7% was significantly associated with moderate-to-severe periodontitis (odds ratio, OR = 1.29; p < 0.01). A predictive model including age, gender, ethnicity, HbA1c and smoking habit as variables had 70.0% sensitivity and 67.6% specificity in detecting moderate-to-severe periodontitis in US adults. CONCLUSIONS:Periodontitis is a common disease in North American adults, and its prevalence is significantly higher in individuals with pre-diabetes or diabetes. The present study demonstrates that a model including age, gender, ethnicity, HbA1c and smoking habit could be used as a reliable screening tool for periodontitis in primary medical care settings to facilitate referral of patients at risk for periodontal examination and diagnosis.

SUBMITTER: Montero E

PROVIDER: S-EPMC7050186 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Development and validation of a predictive model for periodontitis using NHANES 2011-2012 data.

Montero Eduardo E Herrera David D Sanz Mariano M Dhir Sangeeta S Van Dyke Thomas T Sima Corneliu C

Journal of clinical periodontology 20190319 4

<h4>Aim</h4>To develop and validate a predictive model for moderate-to-severe periodontitis in the adult USA population, with data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) cycle.<h4>Material and methods</h4>A subset of 3017 subjects aged >30 years, with >14 teeth present and having received a periodontal examination in addition to data collected on cardio-metabolic risk measures (smoking habit, body mass index [BMI], blood pressure, total cholesterol and glyca ...[more]

PMID: 30891834

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Project description:ObjectivesDiabetes and other metabolic diseases have been linked to the development of periodontitis, but little research has been done to determine whether serum uric acid (SUA) levels and hyperuricemia play a role. This study aimed to investigate the relationship between SUA, hyperuricemia, and periodontitis.MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, we created a nationally representative data set. We used multivariable logistic regression models to assess the relationship between SUA, hyperuricemia, and periodontitis and presented odds ratios (OR) in women and men, respectively.ResultsIn women, adjusted multivariable regression models showed that SUA (4.1-4.3mg/dl) was associated with higher odds of periodontitis (OR = 1.43; 95% confidence interval (CI):1.0 ~ 2.03, p = 0.047) with SUA (≤ 3.3mg/dl) as reference. The risk of periodontitis tended to increase slightly but insignificantly with increasing SUA levels, and the adverse effects occurred only when SUA increased to a certain level, and then reached a plateau. In men, the adjusted OR values for SUA (4.9-5.2mg/dl), SUA (5.3-5.5mg/dl), SUA (5.9-6.2mg/dl), and SUA (6.3-6.5mg/dl) were 0.66 (95% CI: 0.45 ~ 0.96, p = 0.029), 0.58 (95% CI: 0.40 ~ 0.85, p = 0.006), 0.67(95% CI: 0.47 ~ 0.97, p = 0.035), and 0.67 (95% CI: 0.45 ~ 0.99, p = 0.043), respectively, with SUA (≤ 4.3mg/dl) as reference. The elevated SUA levels are protective against periodontitis, but there is a range within which the risk of periodontitis decreases, followed by a non-significant tendency to increase.ConclusionsThe levels of SUA that are linked to the risk of periodontitis. Future prospective longitudinal studies and strategies are required to further confirm whether controlled SUA treatment is an effective adjunct to systematic periodontal therapy and whether SUA can be used as a diagnostic biomarker to assess the risk or progression of periodontitis.

Project description:IntroductionThe Centers for Disease Control and Prevention (CDC) recently found that Asians have considerably higher biomarker levels of cadmium, lead, mercury, and arsenic than whites, blacks, Mexican Americans, and other Hispanics in the United States.ObjectiveOur goal was to further evaluate the higher metal biomarker levels among Asians.MethodsBiomarker data (blood cadmium, blood lead, blood mercury, urinary total arsenic, and urinary dimethylarsinic acic) from individuals ? 6 years of age were obtained from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). We compared geometric mean levels of these five metal biomarkers in Asians with those of four other NHANES race/ethnic groups (white, black, Mexican American, and other Hispanic), and across three Asian subgroups (Chinese, Asian Indian, and other Asian). We also evaluated associations between biomarker levels and sociodemographic, physical, dietary, and behavioral covariates across the Asian subgroups.ResultsAsians had significantly higher levels of all five metal biomarkers than other race/ethnic groups (p < 0.05), regardless of sociodemographic, physical, dietary, behavioral, or geographic characteristics. We also found variations in biomarker levels across the Asian subgroups. In general, Asian Indians had lower levels than the other two Asian subgroups, except for blood lead. The following characteristics were found to be significant predictors of several biomarker levels: sex, age, education, birthplace, smoking, and fish consumption.ConclusionsOverall, the Asian group had the highest geometric mean biomarker levels for all of the five metal variables. Furthermore, we provided evidence that significant variations in the biomarker levels are present across the Asian subgroups in the United States. Citation: Awata H, Linder S, Mitchell LE, Delclos GL. 2017. Biomarker levels of toxic metals among Asian populations in the United States: NHANES 2011-2012. Environ Health Perspect 125:306-313;?http://dx.doi.org/10.1289/EHP27.

Dataset Information

Development and validation of a predictive model for periodontitis using NHANES 2011-2012 data.

Publications

Development and validation of a predictive model for periodontitis using NHANES 2011-2012 data.

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