Observational studyAtherosclerosis2025
Oral microbiome alpha diversity and all-cause, cardiovascular, and non-cardiovascular mortality in US adults: Evidence from the NHANES 2009-2019.
Observational study in Atherosclerosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Association between dental flossing frequency and oral microbiome in U.S. adults.Annals of medicine · 2026Article
- Airway Microbiome Is Associated with Atherosclerosis in Adults from Southern Caribbean.Microorganisms · 2026Article
- Article
- Exploring the oral microbiome diversity and genus signatures associated with a novel non-invasive metabolic indicator: a cross-sectional study.The Saudi dental journal · 2026Article
- Association between the oral microbiota and hyperlipidemia: evidence from a national cross-sectional study.Annals of medicine and surgery (2012) · 2026Article
- Salivary microbiota and clinical periodontal measures predicting cardiometabolic disease mortality: A nationwide survey.Journal of periodontology · 2026Article
- Oral microbiome diversity and all-cause mortality in hypertensive adults: findings from a nationally representative cohort.Journal of oral microbiology · 2026Article
- Oral microbiome diversity and mortality in metabolic syndrome: a cohort study.Journal of oral microbiology · 2026Article
- Unveiling the link between oral microbial α-diversity, advanced cardiovascular-kidney-metabolic syndrome, and mortality.Journal of oral microbiology · 2026Article
- Analysis of ICU resistome dynamics in patients, staff and environment for the identification of predictive biomarkers of sepsis and early mortality.Scientific reports · 2025Article
- Quality of plant-based diets in relation to all-cause and cardiovascular disease mortality in US adults with sarcopenia: a population-based study.Aging clinical and experimental research · 2025Observational
- The oral microbiome and atherosclerosis: current evidence on association, mechanisms, and clinical implications.Frontiers in immunology · 2025Review
- The Oral Microbiota and Its Implications for Inflammatory Bowel Disease: A Literature Review.International journal of general medicine · 2025Review
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
BACKGROUND AND
aimsKnowledge about the association between oral microbiome diversity within individuals and cardiovascular disease (CVD) and non-CVD mortality is scarce. Besides, variation by sex and racial and ethnic groups, and the potential mediators of these associations remain unclear. We aimed to investigate the associations of oral microbiome alpha diversity with all-cause, CVD, and non-CVD mortality, and the interaction effects of sex and racial and ethnic groups and potential mediators in the associations.
methodsThe National Health and Nutrition Examination Survey (NHANES) is a population-based observational study, conducted periodically in Mexican American, Other Hispanic, Non-Hispanic (NH) White, NH Black, and other racial/ethnic participants. We linked 2009-12 survey data of 8199 adults to the mortality data until 2019. By analyzing RNA gene sequences from oral rinse samples, microbiome alpha diversity within individuals was assessed using operational taxonomic unit (OTU) richness. Potential mediators included obesity, diabetes mellitus, dyslipidemia, hypertension, and periodontitis. Multivariable Cox proportional hazards regression and causal mediation analysis were used.
resultsBaseline mean ± standard deviation (SD) age was 42.1 ± 15.1 years. Over a median follow-up of 9.1 years, 405 all-cause mortality occurred (CVD, 105; non-CVD, 300). Each 1-SD increment in OTU richness was inversely associated with all-cause mortality (hazard ratio [HR] 0.92, 95 % confidence interval [CI] 0.90-0.95), CVD mortality (HR, 0.92; 95 % CI, 0.90-0.95), and non-CVD mortality (HR, 0.92; 95 % CI, 0.90-0.95). With evidence of significant racial and ethnic groups-interaction (p <0.05), these associations were evident in Mexican American, NH White, and others racial/ethnic participants. None of the potential mediators significantly mediated the associations of OTU richness with all-cause, CVD, and non-CVD mortality.
conclusionsLower oral microbiome alpha diversity is associated with higher risk for all-cause, CVD, and non-CVD mortality, and the associations are varied by racial and ethnic groups.
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