ArticleDiabetes research and clinical practice2025
Periodontitis, accelerated biological aging, and advanced stages in cardiovascular-kidney-metabolic syndrome in U.S. Adults: A mediation analysis.
Article in Diabetes research and clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Oral health, genetic susceptibility, and risk of dementia: a prospective cohort study of UK Biobank.GeroScience · 2026Article
- Cardiovascular-kidney-metabolic syndrome: a comprehensive review of pathophysiology, epidemiology, diagnosis, and management.Cardiovascular diabetology · 2026Review
- Emerging multidimensional biomarker system for cardiovascular-kidney-metabolic syndrome: from multi-omics integration to clinical artificial intelligence.Cardiovascular diabetology · 2026Review
- Oral health conditions and domain-specific cognitive decline in older adults: evidence from the Baltimore Longitudinal Study of Aging 2005-2024.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Divergent effects of oral health and genetic risk: competing risks of dementia and mortality.Innovation in aging · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
aimsCardiovascular-Kidney-Metabolic (CKM) syndrome is a five-stage framework integrating cardiovascular, renal, and metabolic health. Periodontitis may contribute to multi-system conditions like CKM syndrome, but its overall impact and mechanisms remain unclear.
methodsWe analyzed 3,102 U.S. adults (30-79 years) from NHANES 2009-2014. Periodontal status was classified as none, mild, moderate, or severe; CKM stage (0-4) was determined by clinical criteria. Biological age was estimated via the Klemera-Doubal Method (KDMAge) and Phenotypic Age (PhenoAge) algorithms. Ordinal and binary logistic regression assessed periodontitis-CKM associations, adjusting for sociodemographic and lifestyle factors. Mediation analysis quantified the proportion of this association explained by biological age acceleration (BAA).
resultsAdvanced CKM (stage 3-4) affected 17.8 % of participants. Severe periodontitis versus none/mild was associated with 1.50-fold higher odds of a more advanced CKM stage (95 % CI: 1.15-1.96) and 2.05-fold higher odds of advanced CKM in binary models (95 % CI: 1.50-2.80). Severe periodontitis corresponded to + 1.1 years of KDMAge acceleration and + 1.2 years of PhenoAge acceleration (p < 0.001). BAA mediated 20.1 % of the effect via KDMAge and 13.9 % via PhenoAge (p < 0.001).
conclusionThese findings underscore the importance of integrating oral health into cardiometabolic care, suggesting that addressing periodontal inflammation and BAA could improve CKM outcomes.
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