Hyperuricemia and elevated uric acid/creatinine ratio are associated with stages III/IV periodontitis: a population-based cross-sectional study (NHANES 2009–2014)

Abstract

Abstract Objectives To explore the association between hyperuricemia and having periodontitis. Materials and methods A representative cross-sectional dataset of 10,158 adults was extracted from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. The association between hyperuricemia (the primary exposure) and having periodontitis (outcome) were evaluated using weighted logistic regression models. Serum uric acid (UA) levels and the UA to creatinine (UA/Cr) ratio were used as secondary exposures. Their associations with the diagnosis periodontitis were analyzed using weighted logistic regression or restricted cubic spline regression. Results The prevalence of Stages III/IV periodontitis was 47.7% among individuals with hyperuricemia and 37.4% among those without. After adjustment, individuals with hyperuricemia had 0.281 times higher odds of developing Stages III/IV periodontitis compared to those without hyperuricemia (adjusted OR = 1.286, 95% CI = 1.040 to 1.591, P = 0.024). The increased odds could be explained by a linear relationship with the serum UA/Cr ratio and a U-shaped relationship with serum UA levels. Each unit increase in the serum UA/Cr ratio was associated with 0.048 times higher odds of developing Stages III/IV periodontitis (adjusted OR = 1.048, 95% CI = 1.008 to 1.088, P = 0.021). Additionally, each 1 mg/dL increase in serum UA was associated with 0.156 times higher odds (adjusted OR = 1.156, 95% CI = 1.009 to 1.323, P = 0.038) of developing Stages III/IV periodontitis when UA levels were greater than 5.9 mg/dL, but 0.118 times lower odds when UA levels were 5.9 mg/dL or lower (adjusted OR = 0.882, 95% CI = 0.790 to 0.984, P = 0.027). Sensitivity analyses validated the robustness of the findings. Conclusions This study provides the first direct evidence that hyperuricemia is associated with Stages III/IV periodontitis. Clinical relevance Hyperuricemia may represent a new potential comorbidity of periodontitis, possibly contributing directly or indirectly to the disease burden in patients with periodontitis. Clinical trial number Not applicable.

Keywords

• Hyperuricemia
• Uric acid
• Uric acid to creatinine ratio
• Periodontal diseases
• Urate-lowering therapy