Association Between Serum Albumin and Periodontitis Across Disease Subgroups: A Cross-Sectional Study

Abstract

Purpose

This study examines the association between serum albumin (sALB) levels and periodontitis severity, focusing on subgroup differences and nonlinear relationships. It extends previous findings, which were limited to chronic kidney disease (CKD) patients.

Materials and methods

This cross-sectional study utilized data from 8352 participants in the NHANES 2009 to 2014 survey cycles. sALB and periodontitis were the exposure and outcome variables. Logistic regression models and restricted cubic spline curves were used to investigate the relationship between the two. Additionally, subgroup and interaction analyses were conducted to assess the stability of the findings. All statistical analyses considered the complex survey design.

Results

A significant negative association was observed between sALB and periodontitis status (aOR 0.94, 95% confidence intervals: 0.93-0.96, P value <.001). The strength of this association may be influenced by participants’ gender, CKD status, and hypertension status. Among participants with sALB levels below 35 g/L (defined as hypoalbuminemia), no significant association with periodontitis was observed, even in those with CKD. Restricted cubic spline analysis demonstrated an inverted U-shaped relationship between sALB levels and periodontitis, with a threshold effect at 38 g/L. Above this inflection point, higher sALB levels were significantly associated with a lower prevalence of periodontitis (P < .001).

Conclusions

ALB levels were inversely associated with moderate and severe periodontitis, with an inverted U-shaped relationship observed in this study. The differences among subgroups warrant further research.

Clinical relevance

Maintaining appropriate sALB levels may be beneficial for periodontal health. Further research is needed to confirm its role in periodontitis prevention and treatment.