TY - JOUR
T1 - Periodontal disease, sleep duration, and white blood cell markers in the 2009 to 2014 National Health and Nutrition Examination Surveys
AU - Beydoun, Hind A.
AU - Hossain, Sharmin
AU - Beydoun, May A.
AU - Weiss, Jordan
AU - Zonderman, Alan B.
AU - Eid, Shaker M.
N1 - Funding Information:
The manuscript was supported in part by the Intramural Research Program at the National Institute on Aging and Johns Hopkins University School of Medicine in Baltimore, Maryland. The authors report no conflicts of interest related to this study. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policy or position of Fort Belvoir Community Hospital, the Defense Health Agency, the Department of Defense, or the US Government.
Funding Information:
The manuscript was supported in part by the Intramural Research Program at the National Institute on Aging and Johns Hopkins University School of Medicine in Baltimore, Maryland. The authors report no conflicts of interest related to this study. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policy or position of Fort Belvoir Community Hospital, the Defense Health Agency, the Department of Defense, or the US Government.
Publisher Copyright:
© 2019 American Academy of Periodontology
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Background: Elevated levels of inflammatory biomarkers are consistently associated with chronic conditions, for which periodontitis and sleep are established risk factors. We examined the relationships between periodontitis, hours of sleep and white blood cell (WBC) markers among a nationally representative sample of US adults. Methods: Cross-sectional study using existing demographic, examination, laboratory and questionnaire data on 11,813 participants (5,814 men and 5,999 women, mean age ± SE; range: 52.74 ± 0.24; 30 to 80 years) from the 2009 to 2014 National Health and Nutrition Examination Surveys. Unadjusted, sex- and age-adjusted, as well as fully adjusted linear and logistic regression models were conducted in addition to generalized structural equations models, while considering sampling design complexity. β, odds ratios with their 95% confidence intervals, indirect effects and mediation proportions were estimated. Results: The weighted mean WBC count was 7,130 cells/µL, with the WBC 5-part differential estimated in terms of percentages of lymphocytes (29.50%), monocytes (7.99%), neutrophils (59.03%), eosinophils (2.84%), and basophils (71.88%). Furthermore, 36.2% of participants reported <7 hours of sleep and 49.8% had periodontitis. In fully adjusted models controlling for sociodemographic, lifestyle, and health characteristics, neither WBC markers nor periodontitis were related to hours of sleep. By contrast, periodontitis was directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men. However, the relationship of periodontitis with %neutrophils and %lymphocytes may be modified by hours of sleep, as it was specific to individuals reporting ≥7 hours of sleep. Conclusion: Periodontitis may be directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men and individuals reporting ≥7 hours of sleep, with implications for primary and secondary prevention.
AB - Background: Elevated levels of inflammatory biomarkers are consistently associated with chronic conditions, for which periodontitis and sleep are established risk factors. We examined the relationships between periodontitis, hours of sleep and white blood cell (WBC) markers among a nationally representative sample of US adults. Methods: Cross-sectional study using existing demographic, examination, laboratory and questionnaire data on 11,813 participants (5,814 men and 5,999 women, mean age ± SE; range: 52.74 ± 0.24; 30 to 80 years) from the 2009 to 2014 National Health and Nutrition Examination Surveys. Unadjusted, sex- and age-adjusted, as well as fully adjusted linear and logistic regression models were conducted in addition to generalized structural equations models, while considering sampling design complexity. β, odds ratios with their 95% confidence intervals, indirect effects and mediation proportions were estimated. Results: The weighted mean WBC count was 7,130 cells/µL, with the WBC 5-part differential estimated in terms of percentages of lymphocytes (29.50%), monocytes (7.99%), neutrophils (59.03%), eosinophils (2.84%), and basophils (71.88%). Furthermore, 36.2% of participants reported <7 hours of sleep and 49.8% had periodontitis. In fully adjusted models controlling for sociodemographic, lifestyle, and health characteristics, neither WBC markers nor periodontitis were related to hours of sleep. By contrast, periodontitis was directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men. However, the relationship of periodontitis with %neutrophils and %lymphocytes may be modified by hours of sleep, as it was specific to individuals reporting ≥7 hours of sleep. Conclusion: Periodontitis may be directly related to WBC count and %neutrophils and inversely related to %lymphocytes, especially among men and individuals reporting ≥7 hours of sleep, with implications for primary and secondary prevention.
KW - inflammation
KW - leukocytes
KW - periodontitis
KW - sleep
KW - surveys and questionnaires
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U2 - 10.1002/JPER.19-0055
DO - 10.1002/JPER.19-0055
M3 - Article
C2 - 31554016
AN - SCOPUS:85082942875
SN - 0022-3492
VL - 91
SP - 582
EP - 595
JO - Journal of periodontology
JF - Journal of periodontology
IS - 5
ER -