Association between exposure to multiple polyaromatic hydrocarbons and periodontitis: findings from a cross-sectional study

The impact of environmental pollutant exposure on periodontitis has raised significant concerns. But the association between exposure to multiple polyaromatic hydrocarbons (PAHs) and periodontitis still remained unclear. Our study investigated the association of exposure to multiple PAHs with periodontitis. A total of 1880 participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Urinary samples of the participants exposed to six PAHs, namely, 1-hydroxynaphthalene (1-OHN), 2-hydroxynaphthalene (2-OHN), 3-hydroxyfluorene (3-OHF), 2-hydroxyfluorene (2-OHF), 1-hydroxyphenanthrene (1-OHPhe), and 1-hydroxypyrene (1-OHPyr), were investigated. Multiple logistic regression, restricted cubic spline, and Bayesian kernel machine regression (BKMR) models were employed to identify the association between PAH exposures and periodontitis. The dose-response analysis exhibited a gradual increase in the periodontitis risk with an increase in multiple PAHs. After adjustment for several potential confounders, the odds ratio of the highest quartile (Quartile 4) was 1.648 (95% confidence interval (CI) 1.108-2.456, P = 0.014, P-t = 0.017) for 2-OHN, 2.046 (95%CI 1.352-3.104, P < 0.001, P-t = 0.005) for 3-OHF, 1.996 (95% CI 1.310-3.046, P = 0.001, P-t = 0.003) for 2-OHF, 1.789 (95% CI 1.230-2.604, P = 0.002, P-t = 0.003) for 1-OHPhe, and 1.494 (95% CI 1.025-2.181, P = 0.037, P-t = 0.021) for 1-OHPyr compared with that of the lowest quartile (Quartile 1). BKMR illustrated that the overall effect of the PAH mixture was positively related to periodontitis. Mediation analysis identified blood neutrophils as a partial mediator of 3-OHF and 2-OHF. Exposure to multiple PAHs was positively associated with periodontitis in US adults, and blood neutrophils mediate the effects of 3-OHF and 2-OHF therein.