Association of environmental cadmium exposure with periodontal disease in U.S. adults

Environ Health Perspect. 2009 May;117(5):739-44. doi: 10.1289/ehp.0800312. Epub 2009 Jan 22.

Abstract

Background: Periodontal disease is a complex, multifactorial, chronic inflammatory disease that involves degradation of periodontal structures, including alveolar bone. Cadmium adversely affects bone remodeling, and it is therefore possible that environmental Cd exposure may be a risk factor for periodontal-disease-related bone loss.

Objective: We examined the relationship between environmental Cd exposure and periodontal disease in U.S. adults.

Methods: We analyzed cross-sectional data from the third National Health and Nutrition Examination Survey (NHANES III). We defined periodontal disease as clinical attachment loss of at least 4 mm in > 10% of sites examined. We used multivariable-adjusted logistic regression analyses to estimate the association between creatinine-corrected urinary Cd levels and periodontal disease.

Results: Of the 11,412 participants included in this study, 15.4% had periodontal disease. The age-adjusted geometric mean urine Cd concentration (micrograms per gram creatinine) was significantly higher among participants with periodontal disease [0.50; 95% confidence interval (CI), 0.45-0.56] than among those without periodontal disease (0.30; 95% CI, 0.28-0.31). Multivariable-adjusted analyses, which included extensive adjustments for tobacco exposure, showed that a 3-fold increase in creatinine-corrected urinary Cd concentrations [corresponding to an increment from the 25th (0.18 microg/g) to the 75th (0.63 microg/g) percentile] was associated with 54% greater odds of prevalent periodontal disease (odds ratio = 1.54; 95% CI, 1.26-1.87). We observed similar results among the subset of participants who had limited exposure to tobacco, but only after removing six influential observations.

Conclusion: Environmental Cd exposure was associated with higher odds of periodontal disease.

Keywords: NHANES III; environmental tobacco smoke; periodontal disease; smoking; urine cadmium.

MeSH terms

  • Adolescent
  • Adult
  • Cadmium / toxicity*
  • Cadmium / urine
  • Confidence Intervals
  • Environmental Exposure*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Periodontal Diseases / chemically induced
  • Periodontal Diseases / urine*
  • Smoking / adverse effects
  • United States
  • Water Pollutants, Chemical / toxicity*
  • Water Pollutants, Chemical / urine
  • Young Adult

Substances

  • Water Pollutants, Chemical
  • Cadmium