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Environ Health Perspect. 2009 May;117(5):739-44. doi: 10.1289/ehp.0800312. Epub 2009 Jan 22.

Association of environmental cadmium exposure with periodontal disease in U.S. adults.

Author information

  • 1Population Oral Health, Faculty of Dentistry, Westmead Centre for Oral Health, University of Sydney, Sydney, New South Wales, Australia. marora@hsph.harvard.edu

Abstract

BACKGROUND:

Periodontal disease is a complex, multifactorial, chronic inflammatory disease that involves degradation of periodontal structures, including alveolar bone. Cadmium adversely affects bone remodeling, and it is therefore possible that environmental Cd exposure may be a risk factor for periodontal-disease-related bone loss.

OBJECTIVE:

We examined the relationship between environmental Cd exposure and periodontal disease in U.S. adults.

METHODS:

We analyzed cross-sectional data from the third National Health and Nutrition Examination Survey (NHANES III). We defined periodontal disease as clinical attachment loss of at least 4 mm in > 10% of sites examined. We used multivariable-adjusted logistic regression analyses to estimate the association between creatinine-corrected urinary Cd levels and periodontal disease.

RESULTS:

Of the 11,412 participants included in this study, 15.4% had periodontal disease. The age-adjusted geometric mean urine Cd concentration (micrograms per gram creatinine) was significantly higher among participants with periodontal disease [0.50; 95% confidence interval (CI), 0.45-0.56] than among those without periodontal disease (0.30; 95% CI, 0.28-0.31). Multivariable-adjusted analyses, which included extensive adjustments for tobacco exposure, showed that a 3-fold increase in creatinine-corrected urinary Cd concentrations [corresponding to an increment from the 25th (0.18 microg/g) to the 75th (0.63 microg/g) percentile] was associated with 54% greater odds of prevalent periodontal disease (odds ratio = 1.54; 95% CI, 1.26-1.87). We observed similar results among the subset of participants who had limited exposure to tobacco, but only after removing six influential observations.

CONCLUSION:

Environmental Cd exposure was associated with higher odds of periodontal disease.

KEYWORDS:

NHANES III; environmental tobacco smoke; periodontal disease; smoking; urine cadmium

Comment in

PMID:
19479015
[PubMed - indexed for MEDLINE]
PMCID:
PMC2685835
Free PMC Article
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