title: Associations Between Sex Hormone Levels and Periodontitis in Men: Results From NHANES III.
abstract: BACKGROUND
  Sex hormones are linked to inflammation and bone turnover. The goal of this study is to explore the association between sex hormone levels and periodontitis in men using data from the third National Health and Nutrition Examination Survey (NHANES III).
  
  
  METHODS
  Data from 755 men (aged ≥ 30 years), including serum levels of testosterone, estradiol, sex hormone binding globulin, and androstenediol glucuronide, were analyzed. Calculated bioavailable testosterone (CBT) and estradiol-to-testosterone ratio were calculated. Periodontitis was defined using the latest classification of extent and severity of periodontitis for NHANES data (≥ 2 interproximal sites with ≥ 3 mm attachment loss, ≥ 2 interproximal sites with probing depth [PD] ≥ 4 mm not on the same tooth, or one site with PD ≥ 5 mm). Sex hormones were evaluated as categorized and continuous variables. Correlations between the presence and severity of periodontitis and levels of sex hormones were determined and expressed as odds ratios (ORs).
  
  
  RESULTS
  When adjusted for confounding factors, high total testosterone (TT) and CBT levels correlated with both the prevalence (OR [95% confidence interval (CI)], 2.1 [1 to 4.5] and 3.9 [1 to 14.8], respectively) and severity (OR [95% CI], 2.1 [1 to 4.3] and 3.4 [1.2 to 9.8]) of periodontitis. When continuous variables were used, the ORs (95% CIs) for presence and severity of periodontitis were 1.4 (0.6 to 3.3) and 1.5 (0.6 to 3.6) for TT and 1.3 (0.9 to 1.9) and 1.3 (0.9 to 1.8) for CBT, respectively.
  
  
  CONCLUSIONS
  These findings are consistent with the existence of an association of periodontitis with sex hormone levels, especially testosterone, in men.
authors.affiliation: Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA.|Department of Physiology and Pathology, School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brazil.
authors.forename: Joao Paulo
authors.initials: JP
authors.lastname: Steffens
authors.affiliation: Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA.
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA.|Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA.|Department of Epidemiology, University of Washington, Seattle, WA.
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Starr
authors.affiliation: Department of Physiology and Pathology, School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, SP, Brazil.
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Spolidorio
authors.affiliation: Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Van Dyke
authors.affiliation: Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA.
authors.forename: Alpdogan
authors.initials: A
authors.lastname: Kantarci
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D015114:Androstenediol / Q000097:blood; D001682:Biological Availability; D003920:Diabetes Mellitus / Q000097:blood; D013196:Dihydrotestosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005006:Ethnicity; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D017622:Periodontal Attachment Loss / Q000097:blood; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000097:blood; D010518:Periodontitis / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D012907:Smoking; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio
chemical_list: D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D013739:Testosterone; D004958:Estradiol; D015114:Androstenediol
keywords: Androgens; cross-sectional studies; gonadal steroid hormones; inflammation; periodontitis; testosterone