Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population.
BACKGROUND
Periodontal disease (PD) is a common chronic inflammatory disease and an important risk factor for tooth loss. Vitamin D might affect periodontal disease risk via an effect on bone mineral density (BMD) or via immunomodulatory effects.


OBJECTIVE
The objective was to evaluate whether serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations are associated with PD in the third National Health and Nutrition Examination Survey.


METHODS
We analyzed data on periodontal attachment loss (AL) and serum 25(OH)D(3) concentrations from 11 202 subjects aged > or =20 y. Mean AL was modeled in a multiple linear regression with quintile of serum 25(OH)D(3) concentration as an independent variable. The model was stratified by age and sex and was adjusted for age within age groups, race or ethnicity, smoking, diabetes, poverty income ratio, body mass index, estrogen use, and gingival bleeding.


RESULTS
25(OH)D(3) concentrations were significantly and inversely associated with AL in men and women aged > or =50 y. Compared with men in the highest 25(OH)D(3) quintile, those in the lowest quintile had a mean AL that was 0.39 mm (95% CI: 0.17, 0.60 mm) higher; in women, the difference in AL between the lowest and highest quintiles was 0.26 mm (0.09, 0.43 mm). In men and women younger than 50 y, there was no significant association between 25(OH)D(3) and AL. The BMD of the total femoral region was not associated with AL and did not mediate the association between 25(OH)D(3) and AL.


CONCLUSIONS
Low serum 25(OH)D(3) concentrations may be associated with PD independently of BMD. Given the high prevalence of PD and vitamin D deficiency, these findings may have important public health implications.
Dietrich
Thomas
T
Department of Periodontology and the Department of Oral Surgery and Oral Radiology, Charité, Humboldt University of Berlin, Germany. tdietric@bu.edu
Joshipura
Kaumudi J
KJ
Dawson-Hughes
Bess
B
Bischoff-Ferrari
Heike A
HA
D000328:Adult; D000367:Age Factors; D015519:Bone Density; D002112:Calcifediol / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010510:Periodontal Diseases / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
D002112:Calcifediol