title: Association of internal exposure of cadmium and lead with periodontal disease: a study of the Fourth Korean National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  This study was performed to examine the association of the internal exposure of cadmium and lead with periodontitis in a representative sample of adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES).
  
  
  METHODS
  One thousand nine hundred and sixty-six subjects over the age of 19 who participated in KNHANES were examined. Cadmium (Cd) and lead (Pb) exposure were grouped into three categories: low (<25th percentile), middle (25th-75th percentile) and high (≥75th percentile). The periodontal status was assessed by the Community Periodontal Index. The multivariate logistic regression analysis was performed to get the adjusted odds ratio (OR), and subgroup analysis was also performed. All analyses considered a complex sampling design.
  
  
  RESULTS
  The multivariate logistic regression analysis revealed associations of Cd with periodontitis. Subjects with a high Cd had a 1.57 (95% CI: 1.03-2.38) times higher OR for periodontitis than those with a low Cd. In the subgroup analysis, the association of Pb and Cd with periodontitis was different according to the strata of gender and smoking.
  
  
  CONCLUSIONS
  High Cd could be associated with periodontitis in females and current smokers, and middle Pb showed associations in females and non-smokers among a representative sample of adults in Korea.
authors.affiliation: Department of Dental Hygiene, Byuksung College, Gimje, Korea.
authors.forename: Young-Soon
authors.initials: YS
authors.lastname: Won
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Kwang-Hak
authors.initials: KH
authors.lastname: Bae
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor; D002104:Cadmium / Q000009:adverse effects* / Q000097:blood; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007854:Lead / Q000009:adverse effects* / Q000097:blood; D016015:Logistic Models; D008297:Male; D010512:Periodontal Index; D010518:Periodontitis / Q000097:blood / Q000209:etiology*; D056910:Republic of Korea; D012907:Smoking / Q000009:adverse effects / Q000097:blood; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D002104:Cadmium; D007854:Lead