Abstract
Periodontitis is closely related to lifestyle habits. Our objective was to examine the relationship between the Life's Essential 8 (LE8) and the prevalence of periodontitis in American adults. This study used data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES). LE8 scores (range 0-100) were measured according to the definition by the American Heart Association (AHA) and were categorized as low (0-49), medium (50-79), and high (80-100). The NHANES database on periodontal health was used to data to determine the prevalence of periodontitis. Multivariate regression models and restricted cubic spline (RCS) models were used to assess correlations. Weighted quantile sum (WQS) regression was used to explore the association of LE8 and its components with periodontitis risk. Stratified analysis and interaction analysis were conducted to assess the consistency of the results. In addition, mediation analyses were performed to investigate the role of systemic inflammation in mediating the association of LE8 with periodontitis risk. Participants with moderate (LE8 score 50-79) and high (LE8 score 80-100) scores had 58% (95% CI 0.43-0.79, P < 0.001) and 55% (95% CI 0.37-0.84, P = 0.010) less periodontitis prevalence, respectively, compared with adults with lower total scores. Among all 8 indicators, nicotine exposure (62.3%), blood glucose (18.2%), sleep heath (8.2%), and blood pressure (7.7%) had the most significant impact on periodontitis. Notably, no statistically significant interactions were observed in all subgroup analyses except age (P for interaction < 0.05), indicating that the protective effect of LE8 on periodontitis was shown to be more pronounced in individuals between 40 and 60 years of age. In addition, neutrophil, white blood cell (WBC), and albumin levels mediated the association between LE8 and periodontitis risk, mediating proportions of 13.3%, 21.4%, and 8.3%, respectively. These findings suggest that poorer LE8 scores increase the risk of periodontitis, which may be partly mediated by systemic inflammation.