Association Between Hematological Parameters and Generalized Severe Periodontitis Among Young Adults in the United States

Abstract Background: Generalized severe periodontitis (GSP), a common oral inflammatory disease associated with systemic circulatory disease, can result in tooth loss and chewing dysfunction. Objective: This study aims to investigate the relationship between GSP and systemic circulation-related hematological parameters in young adults aged 30 to 40.Methods: A total of 212 participants were enrolled in the National Health and Nutrition Examination Surveys (NHANES) during 2009 to 2014. The generalized severe periodontitis was identified as 30% of teeth with ≥ 5mm attachment loss. Restricted cubic splines were used to investigate the nonlinearity among variables. Logistic regression analysis was utilized to study the hematological parameters correlated with GSP. Stepwise regression and receiver operating characteristic curve were applied to generate and assess the predictive models for GSP occurrence. Results: Based on the indicators of 212 subjects, we found that generalized severe periodontitis tended to occur in males and was accompanied by higher Hemoglobin (HB), Hematocrit (HCT), Red cell distribution width (RDW), Red blood cell count (RBC), as well as less Poverty-income ratio (PIR). Restricted cubic splines confirmed the relationships between GSP and HB or HCT were nonlinear. Logistic regression showed that RDW was a potential indicator of GSP. Compared with HCT (AUC = 0.702), HB (AUC = 0.697), RBC (AUC = 0.684), RDW (AUC = 0.585), and other single variable, multi-variables regression (including gender, PIR, RDW, education levels, and BMI) (AUC = 0.913) demonstrated better predictive effects on generalized severe periodontitis.Conclusion: Hematological parameters can predict generalized severe periodontitis, for which RDW is a potential indicator.