Red blood cell folate level is associated with periodontitis in American adults: results from the NHANES 2009-2014

• Published in: BMC oral health 2024-07, Vol.24 (1), p.825-10, Article 825
• Main Authors: Liu, Zefei, Luo, Shiyi, Jiao, Ruofeng, Li, Wei, Jin, Fuqian, Sun, Jiangling, Ma, Shu, Song, Jukun, Chen, Zhu
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Blood levels; Body mass index; Care and treatment; Confounding (Statistics); Cross-Sectional Studies; Diabetes; Diagnosis; Disease prevention; Dosage and administration; Erythrocytes; Erythrocytes - metabolism; Ethnicity; Female; Folic acid; Folic Acid - blood; Glucose; Gum disease; Health aspects; Humans; Hygiene; Male; Medical examination; Medical laboratories; Middle Aged; NHANES database; Nutrition; Nutrition Surveys; Nutritional status; Oral hygiene; Periodontitis; Periodontitis - blood; Periodontitis - epidemiology; Quality of life; Red blood cell folate; Smoking; United States - epidemiology; Vitamin B; Womens health
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-024-04599-7

Red blood cell (RBC) folate is an indicator of long-term folate nutrition. Whether there is an association between RBC folate and periodontitis is unclear. This study aimed to use the NHANES database to determine whether RBC folate is associated with moderate/severe periodontitis. A cross-sectional analysis of 10,151 participants in the NHANES database from 2009 to 2014 was performed. Multivariate logistic regression was used to analyze the independent relationship between RBC folate and moderate/severe periodontitis. The generalized additive model (GAM), restricted cubic splines (RCS), smooth curve fitting, and threshold effect analysis were used to explore the dose-response relationship and the potential nonlinear relationship between RBC folate and periodontitis. Finally, subgroup analysis and interaction tests were performed to determine the effect of covariates on the relationship between RBC folate and moderate/severe periodontitis. After adjusting for all confounders, there was a negative association between RBC folate concentration and moderate/severe periodontitis. The lowest fraction Q1 ( 733 ng/mL) categories were 0.88 (0.77, 1.01), 0.83 (0.72, 0.96), 0.77 (0.67, 0.90), 0.65 (0.56, 0.77) respectively. Additionally, a threshold nonlinear association was found between RBC folate (ng/mL) log2 transformation and moderate/severe periodontitis. This cross-sectional study revealed a negative relationship between RBC folate and moderate/severe periodontitis within a certain threshold range. Dentists and policymakers should pay closer attention to oral hygiene and health care for people with low or high RBC folate levels. Further causal and longitudinal research mechanisms are needed to validate our findings.