Abstract
BACKGROUND: To explore the association between periodontitis and all-cause as well as cause-specific mortality rates in U.S. adults with hyperlipidemia. METHODS: Participants were extracted from NHANES during 1988-1994, 1999-2004 and 2009-2014 periods. To assess the association between moderate-to-severe periodontitis and mortality rates for both all-cause and cause-specific mortality, hazard ratios (HRs), time ratios (TRs), and their respective 95% confidence intervals (CIs) were calculated using Cox proportional hazards and Weibull accelerated failure time (AFT) models. RESULTS: Over a median follow-up duration of 11.83 years, 4,623 deaths of 16,848 participants were recorded. Multivariate Cox regression and AFT analyses showed moderate-to-severe periodontitis were associated with an increased risk of all-cause (HR: 1.31, 95% CI: 1.20-1.44, P < 0.001; TR: 0.85, 95% CI: 0.80-0.90, P < 0.001), cardiovascular disease (CVD)-related (HR: 1.36, 95% CI: 1.14-1.63, P = 0.001; TR: 0.83, 95% CI: 0.75-0.92, P < 0.001) and cancer-related mortality ( HR: 1.35, 95% CI: 1.12-1.63, P = 0.002; TR: 0.82, 95% CI: 0.72-0.93, P = 0.002). Meanwhile, there was a significant upward trend in the risk of mortality with increasing severity of periodontitis (P for trend < 0.001). CONCLUSIONS: Our study highlights the moderate-to-severe periodontitis is associated with an increased risk of all-cause, CVD-related and cancer-related mortality among U.S. adults with hyperlipidemia. And the mortality risk increasing alongside the severity of periodontitis.