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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Periodontology and the Department of Oral Surgery and Oral Radiology, Charité, Humboldt University of Berlin, Berlin (TD); the Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany (TD); the Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston (KJJ); the Department of Epidemiology, Harvard School of Public Health, Boston (KJJ); the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston (BD-H); the Division of Aging, Brigham and Women's Hospital, Boston (HAB-F); and the Division of Aging, Harvard Medical School, Boston (HAB-F).
Background: Periodontal disease (PD) is a common chronic inflammatory disease and an important risk factor for tooth loss. Vitamin D might affect periodontal disease risk via an effect on bone mineral density (BMD) or via immunomodulatory effects.
Objective: The objective was to evaluate whether serum 25-hydroxyvitamin D3 [25(OH)D3] concentrations are associated with PD in the third National Health and Nutrition Examination Survey.
Design: We analyzed data on periodontal attachment loss (AL) and serum 25(OH)D3 concentrations from 11 202 subjects aged 
20 y. Mean AL was modeled in a multiple linear regression with quintile of serum 25(OH)D3 concentration as an independent variable. The model was stratified by age and sex and was adjusted for age within age groups, race or ethnicity, smoking, diabetes, poverty income ratio, body mass index, estrogen use, and gingival bleeding.
Results: 25(OH)D3 concentrations were significantly and inversely associated with AL in men and women aged 50 y. Compared with men in the highest 25(OH)D3 quintile, those in the lowest quintile had a mean AL that was 0.39 mm (95% CI: 0.17, 0.60 mm) higher; in women, the difference in AL between the lowest and highest quintiles was 0.26 mm (0.09, 0.43 mm). In men and women younger than 50 y, there was no significant association between 25(OH)D3 and AL. The BMD of the total femoral region was not associated with AL and did not mediate the association between 25(OH)D3 and AL.
Conclusions: Low serum 25(OH)D3 concentrations may be associated with PD independently of BMD. Given the high prevalence of PD and vitamin D deficiency, these findings may have important public health implications.
Key Words: Vitamin D • periodontal disease • periodontal attachment loss • prevention and control • risk factors • National Health and Nutrition Examination Survey • NHANES
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