U-shaped association between pan-immune-inflammation value and periodontitis: NHANES 2009-2014.

ABSTRACT

BACKGROUND: This study aimed to investigate the relationship between the pan-immune-inflammation value (PIV) and periodontitis based on a large national survey. METHODS: In the present cross-sectional study, data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, which included a total of 10,300 participants. The categorization of periodontitis was based on the 2017 classification scheme. The PIV was determined using the formula (neutrophils count × monocyte count × platelet count)/lymphocytes count. Restricted cubic spline and weighted multivariable logistic regression analyses were employed to evaluate the associations between the PIV with periodontitis. RESULTS: The associations between PIV and stage III/IV periodontitis followed a U-shaped pattern (Pnon-linearity < 0.001). The risk of developing stage III/IV periodontitis showed an increasing trend among participants in the first quartile (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.01-1.46), third quartile (OR = 1.34; 95% CI 1.11-1.61), and fourth quartile (OR = 1.47; 95% CI 1.25-1.73) compared to those in the second quartile. Subgroup analysis indicated stronger associations of PIV with periodontitis in males (ORQ4vs2 = 1.72, 95% CI 1.36-2.18) and individuals with hypertension (ORQ4vs2 = 1.78, 95% CI 1.38-2.28) with significant interactions (Pinteraction < 0.05). CONCLUSIONS: There is a U-shaped association between PIV and stage III/IV periodontitis, which suggests a potential adjunctive treatment strategy for periodontitis. Higher PIV values were found to have a stronger correlation with stage III/IV periodontitis in males and individuals with hypertension. Further prospective trials are needed to confirm the validity of our results. PLAIN LANGUAGE SUMMARY: A U-shaped association exists between the pan-immune inflammation value and periodontitis in US adults, suggesting that maintaining a moderate immune inflammation response is crucial for periodontal health.