Abstract
Background: Life’s Essential 8 (LE8), a metric to quantify cardiovascular health, comprises eight elements of health behaviours and lifestyles. There is an interest to understand the distinct effects of individual LE8 elements on periodontal health and whether LE8 predict the risk of periodontitis.
Methods: Pooled cross-sectional data from the National Health and Nutrition Examination Survey in 2009–2014 were used (n = 8,519). Periodontitis was classified into two groups (no/mild and moderate/severe). LE8 score (range 0–100), determined by eight metrics (diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure), was categorized as low (0–49), moderate (50–79), and high (80–100). The LE8–periodontitis association was investigated by multivariable logistic regression and population attributable fraction (PAF). Prediction models for periodontitis using LE8 score were developed, and the performance was tested by the area under the receiver operating characteristic curve (AUC) and calibration curve.
Results: Negative associations were found between LE8 score and periodontitis. Participants with low and moderate LE8 scores had higher risks of periodontitis than those with high LE8 scores (odds ratios [OR] = 4.182 [95%CI = 3.553–4.921], and 2.274 [95%CI = 2.020–2.560], respectively). The PAF analysis showed that 37.794% of periodontitis cases can be attributed to low LE8, among which the effects of blood pressure (PAF = 24.892%), nicotine exposure (PAF = 20.557%), blood lipids (PAF = 19.627%), and diet quality (PAF = 9.252%) were found to be significant. The models constructed using the four LE8 components of blood pressure, nicotine exposure, blood lipids, and diet quality could predict the risk of periodontitis (AUC = 0.744 [0.733, 0.755]).
Conclusion: Worse cardiovascular health, indicated by lower LE8 score, was related to periodontitis risk, and the LE8 score significantly predicted the periodontal health status.