Mediating role of systemic inflammation in the association between heavy metals exposure and periodontitis risk

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Mi Du, Ke Deng, Qingqing Cai, Shixian Hu, Yuntao Chen, Shulan Xu, Geerten-Has E. Tjakkes, Shaohua Ge, Minghua Ge, An Li
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Abstract

Background

This study evaluated the mediating role of systemic inflammation in the association between exposure to heavy metals and periodontitis in a nationwide sample of adults.

Methods

Pooled cross-sectional data from the National Health and Nutrition Examination Survey (NHANES 2009-2014) were used (n = 8993). Periodontitis was defined by a full-mouth examination and classified as no/mild and moderate/severe (mod/sev) groups. Blood and urinary heavy metal levels were investigated, including cadmium (Cd), lead (Pb), and mercury (Hg). In addition, systemic inflammation was assessed using circulatory leukocyte counts and C-reactive protein (CRP) levels.

Results

Multivariable logistic regression analysis revealed the positive associations of blood and urinary levels of Cd and Pb with mod/sev periodontitis. In contrast,blood Hg levels did not show a significant association. The odds of having periodontitis were 1.233 and 1.311 times higher for each one-unit increment in Ln-transformed blood Cd (95% confidence interval [CI]: 1.109–1.371) and Pb (95% CI: 1.170-1.470), respectively. Mediation analysis suggested a 6.3% to 11.5% contribution of leucocyte counts in the association of blood Cd and Pb levels with periodontitis. Sensitivity analyses for urinary Cd levels yielded consistent mediating effects. However, no significant mediating effect of CRP was detected.

Conclusion

Higher exposures to Cd and Pb were positively associated with periodontitis risk. These associations might be partially mediated by the elevated levels of leukocytes rather than CRP. Further longitudinal studies are needed to elucidate the discordant results of the systemic inflammatory biomarkers.

全身炎症在重金属暴露与牙周炎风险之间的中介作用。
背景:本研究在全国成人样本中评估了全身炎症在重金属暴露和牙周炎之间的中介作用。方法:采用国家健康与营养检查调查(NHANES 2009-2014)的汇总横截面数据(n = 8993)。通过全口检查确定牙周炎,并将其分为无/轻度和中度/重度(mod/sev)组。研究了血液和尿液中的重金属水平,包括镉(Cd)、铅(Pb)和汞(Hg)。此外,使用循环白细胞计数和c反应蛋白(CRP)水平评估全身炎症。结果:多变量logistic回归分析显示血、尿Cd、Pb水平与modv /sev牙周炎呈正相关。相比之下,血液中汞含量没有显示出显著的关联。ln转化血Cd(95%可信区间[CI]: 1.109-1.371)和Pb(95%可信区间:1.170-1.470)每增加一个单位,患牙周炎的几率分别高出1.233倍和1.311倍。中介分析表明,白细胞计数在血液Cd和Pb水平与牙周炎的关系中起6.3%至11.5%的作用。尿中Cd水平的敏感性分析得出了一致的中介效应。而CRP未见明显的介导作用。结论:较高的镉、铅暴露与牙周炎风险呈正相关。这些关联可能部分是由白细胞水平升高介导的,而不是CRP。需要进一步的纵向研究来阐明系统性炎症生物标志物的不一致结果。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
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