The Association between Serum Albumin and Periodontitis: A Cross-sectional Study from the NHANES

Background Several studies have been conducted to investigate the effect of nutrienrs on the risk of periodontitis. However, there are few studies on the relationship between serum albumin(SA) and periodontitis. This study aimed to verify the association between SA and periodontitis. Methods Data from the 1999–2000, 2003–2004 and 2009–2014 National Health and Nutrition Examination Survey (NHANES) were used in this study. As the dependent variable, periodontitis was defined by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) in 2012. SA was divided into quartiles as an independent variable to examine variable distribution. Generalized additive model (GAM), smooth curve fitting and threshold effect analysis were used to evaluate the potential nonlinear relationship and dose-response relationship between SA and periodontitis. Results The mean age of the 11,362 participants was 51.96 years, with 49.63% males and 50.37% females. 39.03% of subjects suffered from periodontitis. The mean and standard deviation of SA was 4.26 ± 0.34. After adjusting for confounding factors, SA was independently and negatively associated with periodontitis(OR = 0.65,95%CI 0.57, 0.75, P < 0.0001). Furthermore, after dividing SA into quartiles, we observed a significantly lower risk of periodontitis in the highest quartile(Q4)(OR = 0.67,95%CI 0.59, 0.76), P < 0.0001) compared with the lowest quartile (Q1). Subgroup analyses showed that this inverse association was more significant in men than in women. The smooth curve fitting and threshold effect analysis indicated a non-linear relationship between SA and periodontitis. Specifically, when the SA concentration reached 3.9g/dl, there was a decrease in the risk of periodontitis as the concentration continued to increase. Conclusion This study showed that SA was inversely associated with the prevalence of periodontitis, which was more significant in men. Moreover, this inverse association occurred with SA levels ≥ 3.9g/dl.