Association of Periodontitis With Systemic Lupus Erythematosus in a Large U.S. Population-Based Survey (NHANES III)

Objectives: Objective: The primary objective was to assess the association between Systemic Lupus Erythematosus (SLE) and Periodontitis (PD) in a large US survey.
Methods: Methods: A representative sample of the US population (n= 13,677, NHANES III, 1988-1994) was retrieved and analysed. The association between PD (exposure) and self-reported SLE (outcome) was assessed using multivariate linear and logistic regression models. Additional exposure included serum antibody levels of common periodontal pathogens.
Results: Results: Participants with periodontitis were more likely to have self-reported SLE (OR 2.6 [95%CI 1.1, 6.0]) compared to those without PD. The association was stronger in those participants with moderate periodontitis diagnosis (OR 6.3 [95%CI 1.4, 28.7]). Logistic regression confirmed that participants with greater clinical attachment levels exhibited greater odds of self-reported lupus (OR 1.04 [95%CI 1.01, 1.08]). Case definition and continuous measures of periodontitis were linked to serum antibody levels of Pg and Aa. Participants with higher serum antibody levels of Mm (OR 1.6 [95%CI 1.0, 2.4]) and lower antibody levels of Pg (OR 0.8 [95%CI 0.6, 1.0]) reported higher prevalence of SLE. All findings were independent of age, gender, ethnicity, education, adiposity and smoking differences.
Conclusions: Conclusion: Our data support and association between PD and SLE. Further investigation is required to ascertain the nature of this link and the potential benefit of periodontal treatment on SLE progression and severity.