Abstract
OBJECTIVE: Studies on the relationship between oral microbial diversity and diabetes were limited. This study analyzed the oral microbial composition and diversity using NHANES data to explore its potential role in diabetes pathogenesis; Methods: A cross-sectional design was employed, utilizing NHANES data (2009-2012), including oral microbiota samples and diabetes-related indicators. Oral samples were collected via mouthwash and analyzed using 16 S rRNA gene sequencing. The Shannon-Wiener Index represented microbial diversity (Only bacteria). Multivariate logistic regression, restricted cubic splines, and subgroup analyses were employed to evaluate associations. RESULTS: A significant association was found between oral microbial diversity and diabetes. According to the completely adjusted model, a one-unit increment in the Shannon-Wiener Index was associated with a 12.1% increase in the likelihood of developing diabetes (OR = 1.121, 95%CI: 1.120 ~ 1.122). Subgroup analyses showed divergent findings. In subgroups with lower body weight and BMI, increased microbial diversity correlated with a decreased likelihood of developing diabetes (OR = 0.68 (0.68-0.68)); Conclusions: Oral microbial diversity exhibits a complex relationship with diabetes risk. The increase and subsequent decrease of oral microbiota diversity in relation to diabetes risk. This suggests that certain specific microbes or interactions between microbes may influence the development of diabetes. However, due to the many limitations of this study, it cannot prove the causal relationship between oral microbial richness and diabetes. Further longitudinal and mechanistic studies are essential to elucidate the causal links and dynamic alterations between the oral microbiome and the progression of diabetes.