The regulatory effect of zinc on the association between periodontitis and atherosclerotic cardiovascular disease: a cross-sectional study based on the National Health and Nutrition Examination Survey

Background Zinc has been proven to be effective against periodontitis, and also reported to reduce the risk of cardiovascular diseases (CVD). This study aims to explore the regulatory effect of zinc intake on the association between periodontitis and atherosclerotic cardiovascular disease (ASCVD). Methods This was a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). Logistic regression model was used to explore the association between zinc-RDA or periodontitis and 10-year ASCVD risk >= 20%, and results were shown as odds ratio (OR) and 95% confidence interval (95% CI). The regulatory effect of zinc intake on the association between periodontitis and 10-year ASCVD risk >= 20% was also assessed using logistic regression model. Subgroup analysis was performed based on age, gender, obesity, education level, lipid-lowering therapy, and dental floss. Results 6,075 patients were finally included for analysis. Zinc intake reaching the recommended level (OR = 0.82, 95%CI: 0.69-0.98) and periodontitis (OR = 2.47, 95%CI: 2.04-3.00) were found to be associated with 0.82-fold and 2.47-fold odds of 10-year ASCVD risk >= 20%, respectively. In addition, we found that the odds of 10-year ASCVD risk >= 20% was lower in patients with zinc intake reaching the recommended level than those without [OR (95%CI): 2.25 (1.81-2.80) vs. 2.72 (2.05-3.62)]. The similar regulatory effect was found in patients with age >= 60 years and < 60 years, in male and female, with or without obesity, in different education levels, with or without lipid lowering therapy, and with or without use of dental floss (all P < 0.05). Conclusions This study found the regulatory effect of adequate zinc intake on the association between periodontitis and ASCVD, providing guidance for periodontitis patients to decrease the risk of ASCVD.