Cross-sectional study of the association of vitamins C and D with periodontal status

In-Ja Kim; Heung-Soo Lee; Hyun-Jeong Ju; Ja-Young Na; Hyo-Won Oh

doi:10.11149/jkaoh.2016.40.4.215

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Kim, Lee, Ju, Na, and Oh: Cross-sectional study of the association of vitamins C and D with periodontal status

Original Article

J Korean Acad Oral Health 2016;40(4):215-221.

Published online: 15 December 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.4.215

Cross-sectional study of the association of vitamins C and D with periodontal status

In-Ja Kim¹, Heung-Soo Lee^1,², Hyun-Jeong Ju¹, Ja-Young Na¹, Hyo-Won Oh^1,^2,

¹Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, Iksan, Korea

²WBMI and Institute of Wonkwang Dental Research, College of Dentistry, Wonkwang University, Iksan, Korea

Corresponding Author: Hyo-Won Oh Department of Preventive and Public Health Dentistry, WBMI and Institute of Wonkwang Dental Research, College of Dentistry, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Korea Tel: +82-63-850-6928 Fax: +82-63-857-4837 E-mail: dhdh@wonkwang.ac.kr

Received 8 September 2016 Revised 19 October 2016 Accepted 8 November 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to examine the association between vitamin C, vitamin D, and periodontal diseases in adults.

Methods

The data used for analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (2013-2014). Subjects were 2,702 adults aged from 19 to 64 years. Complex Chi-square tests and complex logistic regression analyses were used to assess the association between vitamins and periodontal status.

Results

There is no statistically significant association between vitamin C intake and periodontal status. Periodontal status of subjects with a low vitamin D (25-hydroxyvitamin D) level was better than that of the subjects with a high level (P<0.05). However, multivariate analysis demonstrated that this association is not statistically significant.

Conclusions

More follow-up studies are necessary to determine the association of the vitamins C and D with the periodontal diseases.

Keywords: Adults, Periodontal diseases, Sixth Korean National Health and Nutrition Examination Survey, Vitamin C, Vitamin D

References

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Table 1.

Periodontal status according to characteristics of subject Unit : N (weighted %

		Periodontal status			Periodontal disease
		Healthy	Non-Healthy	P*	No	Yes	P*
Gender	Female	522 (36.7)	950 (63.3)	<0.001	1,201 (83.1)	271 (16.9)	<0.001
	Male	301 (26.3)	929 (73.7)		853 (73.0)	377 (27.0)
Age	19-29	280 (43.0)	351 (57.0)	<0.001	607 (95.7)	24 (4.3)	<0.001
	30-49	373 (27.8)	901 (72.2)		997 (76.0)	277 (24.0)
	50-64	170 (19.5)	627 (80.5)		450 (54.5)	347 (45.5)
House income	Low	151 (21.0)	524 (79.0)	<0.001	488 (75.4)	187 (24.6)	0.178
	Low-middle	205 (30.9)	485 (69.1)		517 (75.3)	173 (24.7)
	High-middle	230 (35.1)	449 (64.9)		529 (78.9)	150 (21.1)
	High	234 (36.2)	416 (63.8)		514 (80.1)	136 (19.9)
Education	≤Primary school	30 (10.7)	200 (89.3)	<0.001	115 (45.7)	115 (54.3)	<0.001
	Middle school	37 (18.9)	167 (81.1)		132 (65.3)	72 (34.7)
	High school	329 (30.5)	736 (69.5)		828 (79.0)	237 (21.0)
	≥College	388 (36.3)	662 (63.7)		872 (83.2)	178 (16.8)
Drinking experience	No	59 (33.0)	124 (67.0)	0.590	132 (72.8)	51 (27.2)	0.188
	Yes	739 (30.9)	1,681 (69.1)		1,853 (77.9)	567 (22.1)
Smoking experience	No	564 (36.9)	1,020 (63.1)	<0.001	1,293 (83.5)	291 (16.5)	<0.001
	Yes	234 (24.0)	784 (76.0)		692 (70.7)	326 (29.3)
Diabetes	No	761 (31.2)	1,699 (68.8)	0.112	1,904 (78.6)	556 (21.4)	<0.001
	Yes	24 (22.5)	69 (77.5)		45 (49.8)	48 (50.2)
Frequency of tooth brushing	≤1	40 (20.7)	169 (79.3)	<0.001	133 (65.3)	76 (34.7)	<0.001
	2	248 (27.7)	659 (72.3)		674 (75.4)	233 (24.6)
	3	352 (33.1)	690 (66.9)		824 (80.4)	218 (19.6)
	≥4	158 (38.3)	284 (61.7)		351 (81.8)	91 (18.2)
Use of oral hygiene devices	No	281 (25.1)	902 (74.9)	<0.001	865 (75.2)	318 (24.8)	0.017
	Yes	526 (36.1)	932 (63.9)		1,145 (79.5)	313 (20.5)
Vitamin D (2 category)	<20 ng	657 (31.9)	1,399 (68.1)	0.049	1,611 (79.2)	445 (20.8)	<0.001
	≥20 ng	166 (26.9)	480 (73.1)		443 (71.2)	203 (28.8)
Vitamin D (4 category)	1 quartile	234 (35.1)	441 (64.9)	0.046	549 (83.1)	126 (16.9)	<0.001
	2 quartile	207 (30.3)	469 (69.7)		519 (77.3)	157 (22.7)
	3 quartile	209 (30.6)	467 (69.4)		521 (77.3)	155 (22.7)
	4 quartile	173 (26.6)	502 (73.4)		465 (71.3)	210 (28.7)
Vitamin C (2 category)	<100 mg	518 (30.0)	1,239 (70.0)	0.228	1,124 (78.0)	355 (22.0)	0.509
	≥100 mg	303 (32.5)	633 (67.5)		923 (76.6)	291 (23.4)
Vitamin C (4 category)	1 quartile	192 (29.1)	477 (70.9)	0.457	520 (79.8)	149 (20.2)	0.385
	2 quartile	205 (29.7)	493 (70.3)		517 (75.9)	181 (24.1)
	3 quartile	217 (33.1)	459 (66.9)		510 (77.1)	166 (22.9)
	4 quartile	208 (31.5)	450 (68.5)		506 (76.5)	152 (23.5)

The data were analysed by reflecting complex weighted sample design. *Chi-square test.

Table 2.

Multivariate analysis of the relationship between periodontal status and blood 25(OH)D

		Periodontal status
		B	S.E	OR (95% CI)	P-value*
Gender	Female	.260	.124	1.297 (1.016-1.656)	0.037
	Male			1.000 (reference)
Age		―.033	.005	0.968 (0.958-0.977)	<0.001
House income	Low	―.650	.160	0.522 (0.382-0.715)	<0.001
	Low-middle	―.209	.140	0.812 (0.616-1.069)	0.137
	High-middle	―.077	.145	0.926 (0.696-1.231)	0.596
	High			1.000 (reference)
Education	≤Primary school	―.828	.273	0.437 (0.255-0.747)	0.003
	Middle school	―.270	.267	0.764 (0.452-1.291)	0.313
	High school	―.195	.108	0.823 (0.666-1.018)	0.072
	≥College			1.000 (reference)
Drinking experience	No	.165	.195	1.179 (0.803-1.732)	0.399
	Yes			1.000 (reference)
Smoking experience	No	.403	.133	1.496 (1.151-1.945)	0.003
	Yes			1.000 (reference)
Diabetes	No	―.262	.297	0.769 (0.429-1.381)	0.379
	Yes			1.000 (reference)
Frequency of tooth brushing		.121	.057	1.129 (1.009-1.264)	0.034
Use of oral hygiene devices	No	―.425	.108	0.654 (0.528-0.809)	<0.001
	Yes			1.000 (reference)
Vitamin D (4 category)	1 quartile	.133	.156	1.143 (0.840-1.554)	0.393
	2 quartile	―.042	.158	0.959 (0.704-1.308)	0.792
	3 quartile	.061	.148	1.063 (0.795-1.422)	0.678
	4 quartile			1.000 (reference)

The data were analysed by reflecting complex weighted sample design. *Logistic regression.

Table 3.

Multivariate analysis of the relationship between periodontal disease and blood 25(OH)D

		Periodontal disease
		B	S.E	OR (95% CI)	P-value*
Gender	Female	.514	.136	1.672 (1.279-2.187)	<0.001
	Male			1.000 (reference)
Age		―.079	.005	0.924 (0.915-0.934)	<0.001
House income	Low	―.159	.187	0.853 (0.590-1.234)	0.398
	Low-middle	―.200	.187	0.819 (0.567-1.183)	0.286
	High-middle	―.044	.180	0.957 (0.671-1.364)	0.808
	High			1.000 (reference)
Education	≤Primary school	―.644	.222	0.525 (0.339-0.813)	0.004
	Middle school	.004	.216	1.004 (0.657-1.536)	0.984
	High school	―.337	.129	0.714 (0.555-0.920)	0.009
	≥College			1.000 (reference)
Drinking experience	No	―.143	.264	0.867 (0.516-1.458)	0.590
	Yes			1.000 (reference)
Smoking experience	No	.515	.138	1.674 (1.275-2.198)	<0.001
	Yes			1.000 (reference)
Diabetes	No	.257	.272	1.293 (0.756-2.209)	0.347
	Yes			1.000 (reference)
Frequency of tooth brushing		.084	.065	1.088 (0.957-1.238)	0.198
Use of oral hygiene devices	No	―.103	.117	0.902 (0.718-1.135)	0.378
	Yes			1.000 (reference)
Vitamin D (4 category)	1 quartile	.100	.185	1.105 (0.768-1.591)	0.590
	2 quartile	―.135	.167	0.873 (0.629-1.213)	0.419
	3 quartile	―.028	.166	0.972 (0.702-1.346)	0.865
	4 quartile			1.000 (reference)

The data were analysed by reflecting complex weighted sample design. *Logistic regression.

Table 4.

Multivariate analysis of the relationship between periodontal status and vitamin C

		Periodontal status
		B	S.E	OR (95% CI)	P-value*
Gender	Female	.284	.123	1.329 (1.044-1.691)	0.021
	Male			1.000 (reference)
Age		―.035	.005	0.965 (0.956-0.975)	<0.001
House income	Low	―.618	.159	0.539 (0.934-0.737)	<0.001
	Low-middle	―.179	.139	0.836 (0.636-1.100)	0.201
	High-middle	―.057	.146	0.945 (0.709-1.258)	0.696
	High			1.000 (reference)
Education	≤Primary school	―.804	.272	0.448 (0.262-0.764)	0.003
	Middle school	―.246	.267	0.782 (0.462-1.323)	0.359
	High school	―.174	.106	0.840 (0.682-1.036)	0.103
	≥College			1.000 (reference)
Drinking experience	No	.178	.194	1.195 (0.815-1.750)	0.360
	Yes			1.000 (reference)
Smoking experience	No	.394	.132	1.483 (1.143-1.924)	0.003
	Yes			1.000 (reference)
Diabetes	No	―.291	.297	0.748 (0.417-1.342)	0.329
	Yes			1.000 (reference)
Frequency of tooth brushing		.116	.057	1.123 (1.004-1.257)	0.043
Use of oral hygiene devices	No	―.412	.109	0.663 (0.535-0.821)	<0.001
	Yes			1.000 (reference)
Vitamin C (4 category)	1 quartile	―.216	.145	0.806 (0.606-1.072)	0.137
	2 quartile	―.064	.142	0.938 (0.709-1.241)	0.653
	3 quartile	.039	.135	1.040 (0.796-1.357)	0.775
	4 quartile			1.000 (reference)

The data were analysed by reflecting complex weighted sample design. *Logistic regression.

Table 5.

Multivariate analysis of the relationship between periodontal disease and vitamin C

		Periodontal disease
		B	S.E	OR (95% CI)	P-value*
Gender	Female	.518	.135	1.679 (1.286-2.192)	<0.001
	Male			1.000 (reference)
Age		―.080	.005	0.923 (0.913-0.933)	<0.001
House income	Low	―.124	.191	0.884 (0.607-1.287)	0.518
	Low-middle	―.167	.186	0.846 (0.587-1.221)	0.371
	High-middle	―.039	.180	0.962 (0.674-1.372)	0.830
	High			1.000 (reference)
Education	≤Primary school	―.644	.224	0.525 (0.338-0.815)	0.004
	Middle school	.016	.220	1.016 (0.659-1.567)	0.943
	High school	―.330	.129	0.719 (0.557-0.927)	0.011
	≥College			1.000 (reference)
Drinking experience	No	―.142	.262	0.868 (0.518-1.454)	0.589
	Yes			1.000 (reference)
Smoking experience	No	.507	.138	1.660 (1.265-2.178)	<0.001
	Yes			1.000 (reference)
Diabetes	No	.232	.267	1.261 (0.746-2.134)	0.385
	Yes			1.000 (reference)
Frequency of tooth brushing		.078	.066	1.081 (0.950-1.230)	0.238
Use of oral hygiene devices	No	―.081	.118	0.922 (0.731-1.162)	0.490
	Yes			1.000 (reference)
Vitamin C (4 category)	1 quartile	―.190	.184	0.827 (0.576-1.187)	0.302
	2 quartile	―.336	.176	0.714 (0.506-1.009)	0.056
	3 quartile	―.181	.162	0.834 (0.606-1.148)	0.266
	4 quartile			1.000 (reference)

The data were analysed by reflecting complex weighted sample design. *Logistic regression.

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