The association of aldehyde exposure with the risk of periodontitis: NHANES 2013-2014

Clin Oral Investig. 2023 Dec 26;28(1):29. doi: 10.1007/s00784-023-05451-y.


Objectives: Three distinct models were utilized to investigate the combined impacts of serum aldehyde exposure and periodontitis.

Materials and methods: We performed a cross-sectional analysis using data from 525 participants in the 2013-2014 National Health and Nutrition Examination Survey (NHANES). The directed acyclic graphs (DAG) were used to select a minimal sufficient adjustment set of variables (MSAs). To investigate the relationship between aldehydes and periodontitis, we established three models including multiple logistic regression model, restricted cubic spline (RCS) model, and Bayesian kernel machine regression (BKMR) model.

Results: After taking all covariates into account, the multiple logistic regression model revealed that elevated concentrations of isopentanaldehyde and propanaldehyde were strongly associated with periodontitis (isopentanaldehyde: OR: 2.38, 95% CI: 1.34-4.23; propanaldehyde: OR: 1.51, 95% CI: 1.08-2.13). Furthermore, the third tertile concentration of isopentanaldehyde was associated with a 2.04-fold increase in the incidence of periodontitis (95% CI: 1.05-3.95) compared to the first tertile concentration, with a P for trend = 0.04. RCS models showed an "L"-shaped relationship between isopentanaldehyde and periodontitis (P for nonlinear association < 0.01), with inflection point of 0.43 ng/mL. BKMR identified a strong connection between mixed aldehydes and periodontitis, with isopentanaldehyde exhibiting the greatest posterior inclusion probability (PIP) with 0.901 and propanaldehyde exhibiting a PIP with 0.775.

Conclusions: Isopentanaldehyde and propanaldehyde are positively associated with the risk of periodontitis.

Clinical relevance: Periodontitis may be associated with exposure to mixed aldehyde. This study emphasizes the important role of aldehydes in primary prevention of periodontitis.

Keywords: Aldehydes; Bayesian kernel machine regression; Logistic models; NHANES; Periodontitis; Restricted cubic spline.

Publication types

  • Review

MeSH terms

  • Aldehydes* / adverse effects
  • Bayes Theorem
  • Cross-Sectional Studies
  • Humans
  • Nutrition Surveys
  • Periodontitis* / epidemiology


  • Aldehydes