Association between Multivitamin Supplements and Periodontitis in Postmenopausal Women

Objectives: To evaluate the association between multivitamin supplements (MS) and the severity of periodontitis in postmenopausal women (PMW) and to delineate demographic, lifestyle factors, anthropometric measurements and pre-existing diseases associated with MS intake.
Methods: Retrospective, cross-sectional study was conducted using the Case Cleveland Clinic Postmenopausal Wellness Consortium (CCCPWC), a database of over 900 PMW. Subjects were divided into two groups (MS users, n=278; nonusers, n=511) and classified according to periodontal severity: healthy, mild, moderate, and severe periodontitis. Periodontal parameters including: median number of teeth loss (MNTL), median probing depth (MPD), median recession (MR), and bleeding on probing (BOP) were recorded. Additionally, anthropometric measurements: body mass index (BMI) and fracture risk assessment tool (FRAX) score, lifestyle factors: MS intake, smoking status, and average alcohol consumption (AAC), socio-economic status: ethnicity, household income, and education level, and pre-existing diseases: secondary osteoporosis, and diabetes were collected. Data were analyzed using the Pearson’s chi-square, and Mann-Whitney U test (α = 0.05). Logistic regression model was used to predict the likelihood of MS intake with covariates of interest.
Results: There were significant differences in BOP, MNTL, and FRAX score (osteoporotic fracture) between MS users and non-users: (73.5% vs. 56.8%; p<0.001), (8, 0-32 vs. 5, 0-32; p<0.001), and (1.8, 0.5-54.9 vs. 1.6, 0.4-36.2; p=0.043), respectively. BMI, and smoking were inversely related with MS users compared to non-users, (25.3, 12.9-53.8 vs. 26.1, 13.5-62.5; p=0.049), and (7.6% vs. 19.0%; p<0.001), respectively. When adjusting for potential confounders, FRAX score was the strongest predictor of MS intake in PMW (OR 1.8; 95% CI 1.2, 2.8; p=0.009).
Conclusions: BOP, MNTL, FRAX score, BMI, and smoking are significantly associated with multivitamin supplement intake. MS intake does not appear to significantly influence the severity of periodontal disease in PMW. Additional longitudinal research is needed to further understand the potential causal relationship between MS and periodontitis in PMW.