The Relationship Between Vitamin D, Cardiovascular Health, and Periodontitis in US Adults

Background Vitamin D deficiency is a prevalent public health issue, and serum vitamin D concentrations are linked to the risk of periodontitis. This study aims to investigate the relationship between these two variables and to determine whether this association is influenced by various factors, particularly focusing on the mediating effect of cardiovascular health (CVH). Methods Data was extracted from the National Health and Nutrition Examination Survey (NHANES) database for the years 2009–2014 in this cross-sectional study. The association between vitamin D and periodontitis was examined using univariate and multivariate logistic regression analyses, as well as restricted cubic spline models. Additionally, subgroup analyses and restricted cubic splines were employed to assess the effects of glucose tolerance status, age, gender, smoking status, and alcohol consumption on the association. Mediation analysis was conducted to explore whether LE8 scores serve as a mediator in the relationship between vitamin D and periodontitis. Results Among 12,714 adults, 4,522 (35.5%) were diagnosed with periodontitis, with the proportions of Mild, Moderate, and Severe Chronic Periodontitis being 279 (2.2%), 3,438 (27.0%), and 805 (6.3%), respectively. After fully adjusting for confounding factors, negative associations were observed between vitamin D levels and periodontitis. Quartile comparisons indicated Q2: 0.91 (0.82 ~ 1.00), Q3: 0.88 (0.79 ~ 0.99), and Q4: 0.89 (0.78 ~ 1.01). In subgroup analyses, vitamin D was significantly associated with periodontitis across various strata, including age, sex, and glucose tolerance status. Interaction analysis revealed that age significantly influenced the relationship between vitamin D and periodontitis. Mediation analyses utilizing Life's Essential 8 (LE8) assessed cardiovascular health (CVH), demonstrating that the LE8 score and health factor score mediated the relationship between vitamin D and periodontitis, with mediation proportions of 8.71% and 7.11%, respectively. Conclusion We concluded that increased vitamin D levels were associated with a decreased risk of periodontitis. The LE8 score and health factor score demonstrated critical mediating effects in the relationship between vitamin D and periodontitis. This study highlighted the intricate interplay among vitamin D, cardiovascular health (CVH), and periodontitis, providing insights into potential avenues for intervention and management.