Abstract：
OBJECTIVE: To ascertain whether healthy lifestyles are associated with periodontal diseases in two large-scale surveys in the US (National Health and Nutrition Examination Survey - NHANES) and the UK Biobank.
METHODS: 9854 US adults and 111 679 UK adults were included in the analyses. A healthy lifestyle score (HLS), ranging between 0 and 5, was calculated based on the reported number of healthy behaviours, including never smoking, no heavy alcohol consumption, top third of leisure-time physical activity, higher dietary quality, and ideal sleep duration. The prevalence of periodontal diseases was the primary outcome in both surveys. In the NHANES, periodontal status was assessed through a full-mouth periodontal examination, while in the UKB, only self-reported periodontal status was available.
RESULTS: Multiple regression analyses confirmed that the presence of at least 2-3 healthy behaviours (vs. 0-1) was associated with lower odds of overall and severe periodontitis (ORs 0.5, 0.4-0.6; p < .001 and 0.5, 0.3-0.8; p = .003, respectively) in the NHANES, and of bleeding gums (OR = 0.9, 0.8-1.0; p = .092) and loose teeth (OR = 0.6, 0.5-0.7; p < .001) in UKB. This association increased when considering prevalence of 4-5 healthy behaviours (vs. 0-1) in both the NHANES (periodontitis: OR = 0.3, 0.2-0.4; p < .001; severe periodontitis: OR = 0.1, 0.01-0.2; p < .001) and the UKB (bleeding gums: OR = 0.8, 0.7-0.9; p < .001; loose teeth: OR = 0.5, 0.4-0.6; p < .001). Mediation analyses revealed how these protective associations could be partially mediated (1-14%) by differences in biomarkers of systemic inflammation (white blood cells and neutrophils count as well as C-reactive protein).
CONCLUSIONS: Adoption of healthy lifestyle behaviours is associated with a lower prevalence of periodontal diseases within two large population-based samples. This relationship exhibits a dose-response pattern, implying that greater adherence to healthy habits leads to a more significant protective effect against the odds of periodontal diseases. Additionally, our findings suggest that this protective effect is, in part, mediated by reductions in systemic inflammation.
METHODS: 9854 US adults and 111 679 UK adults were included in the analyses. A healthy lifestyle score (HLS), ranging between 0 and 5, was calculated based on the reported number of healthy behaviours, including never smoking, no heavy alcohol consumption, top third of leisure-time physical activity, higher dietary quality, and ideal sleep duration. The prevalence of periodontal diseases was the primary outcome in both surveys. In the NHANES, periodontal status was assessed through a full-mouth periodontal examination, while in the UKB, only self-reported periodontal status was available.
RESULTS: Multiple regression analyses confirmed that the presence of at least 2-3 healthy behaviours (vs. 0-1) was associated with lower odds of overall and severe periodontitis (ORs 0.5, 0.4-0.6; p < .001 and 0.5, 0.3-0.8; p = .003, respectively) in the NHANES, and of bleeding gums (OR = 0.9, 0.8-1.0; p = .092) and loose teeth (OR = 0.6, 0.5-0.7; p < .001) in UKB. This association increased when considering prevalence of 4-5 healthy behaviours (vs. 0-1) in both the NHANES (periodontitis: OR = 0.3, 0.2-0.4; p < .001; severe periodontitis: OR = 0.1, 0.01-0.2; p < .001) and the UKB (bleeding gums: OR = 0.8, 0.7-0.9; p < .001; loose teeth: OR = 0.5, 0.4-0.6; p < .001). Mediation analyses revealed how these protective associations could be partially mediated (1-14%) by differences in biomarkers of systemic inflammation (white blood cells and neutrophils count as well as C-reactive protein).
CONCLUSIONS: Adoption of healthy lifestyle behaviours is associated with a lower prevalence of periodontal diseases within two large population-based samples. This relationship exhibits a dose-response pattern, implying that greater adherence to healthy habits leads to a more significant protective effect against the odds of periodontal diseases. Additionally, our findings suggest that this protective effect is, in part, mediated by reductions in systemic inflammation.
摘要：
目的：在美国（国家健康和营养调查-NHANES）和英国生物银行的两项大规模调查中，确定健康的生活方式是否与牙周疾病有关。
方法：9854名美国成年人和111679名英国成年人被纳入分析。健康生活方式评分（HLS），范围在0到5之间，是根据报告的健康行为数量计算的，包括从不吸烟,没有大量饮酒，休闲时间体育活动的前三分之一，更高的饮食质量，和理想的睡眠时间。在两项调查中，牙周疾病的患病率是主要结果。在NHANES，通过全口牙周检查评估牙周状况，而在UKB中，只有自我报告的牙周状况可用.
结果：多元回归分析证实存在至少2-3种健康行为（与0-1）与NHANES中总体和严重牙周炎的较低几率（ORs0.5，0.4-0.6;p<.001和0.5，0.3-0.8;p=.003）相关，以及UKB中牙龈出血（OR=0.9，0.8-1.0；p=0.092）和牙齿松动（OR=0.6，0.5-0.7；p<.001）。当考虑到4-5种健康行为的患病率时，这种关联增加(vs.0-1）在NHANES（牙周炎：OR=0.3，0.2-0.4；p<.001；严重牙周炎：OR=0.1，0.01-0.2；p<.001）和UKB（牙龈出血：OR=0.8，0.7-0.9；p<.001；牙齿松动：OR=0.5，0.4-0.6；p<.001）。中介分析揭示了这些保护性关联如何通过系统性炎症的生物标志物（白细胞和中性粒细胞计数以及C反应蛋白）的差异部分介导（1-14％）。
结论：在两个基于人群的大样本中，采用健康的生活方式行为与牙周疾病患病率较低相关。这种关系表现出剂量反应模式，这意味着对健康习惯的更坚持会导致对牙周疾病的可能性产生更显著的保护作用。此外,我们的研究结果表明，这种保护作用是，在某种程度上,通过减少全身性炎症介导。
方法：9854名美国成年人和111679名英国成年人被纳入分析。健康生活方式评分（HLS），范围在0到5之间，是根据报告的健康行为数量计算的，包括从不吸烟,没有大量饮酒，休闲时间体育活动的前三分之一，更高的饮食质量，和理想的睡眠时间。在两项调查中，牙周疾病的患病率是主要结果。在NHANES，通过全口牙周检查评估牙周状况，而在UKB中，只有自我报告的牙周状况可用.
结果：多元回归分析证实存在至少2-3种健康行为（与0-1）与NHANES中总体和严重牙周炎的较低几率（ORs0.5，0.4-0.6;p<.001和0.5，0.3-0.8;p=.003）相关，以及UKB中牙龈出血（OR=0.9，0.8-1.0；p=0.092）和牙齿松动（OR=0.6，0.5-0.7；p<.001）。当考虑到4-5种健康行为的患病率时，这种关联增加(vs.0-1）在NHANES（牙周炎：OR=0.3，0.2-0.4；p<.001；严重牙周炎：OR=0.1，0.01-0.2；p<.001）和UKB（牙龈出血：OR=0.8，0.7-0.9；p<.001；牙齿松动：OR=0.5，0.4-0.6；p<.001）。中介分析揭示了这些保护性关联如何通过系统性炎症的生物标志物（白细胞和中性粒细胞计数以及C反应蛋白）的差异部分介导（1-14％）。
结论：在两个基于人群的大样本中，采用健康的生活方式行为与牙周疾病患病率较低相关。这种关系表现出剂量反应模式，这意味着对健康习惯的更坚持会导致对牙周疾病的可能性产生更显著的保护作用。此外,我们的研究结果表明，这种保护作用是，在某种程度上,通过减少全身性炎症介导。
