U‐shaped association between pan‐immune‐inflammation value and periodontitis: NHANES 2009–2014

Abstract Background This study aimed to investigate the relationship between the pan‐immune‐inflammation value (PIV) and periodontitis based on a large national survey. Methods In the present cross‐sectional study, data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009–2014, which included a total of 10,300 participants. The categorization of periodontitis was based on the 2017 classification scheme. The PIV was determined using the formula: (neutrophils count × monocyte count × platelet count)/lymphocytes count. Restricted cubic spline and weighted multivariable logistic regression analyses were employed to evaluate the associations between the PIV with periodontitis. Results The associations between PIV and stage III/IV periodontitis followed a U‐shaped pattern ( P non‐linearity < 0.001). The risk of developing stage III/IV periodontitis showed an increasing trend among participants in the first quartile (odds ratio [OR] = 1.21; 95% confidence interval [CI]: 1.01–1.46), third quartile (OR = 1.34; 95% CI: 1.11–1.61), and fourth quartile (OR = 1.47; 95% CI: 1.25–1.73) compared to those in the second quartile. Subgroup analysis indicated stronger associations of PIV with periodontitis in males (OR Q4vs2 = 1.72, 95% CI: 1.36–2.18) and individuals with hypertension (OR Q4vs2 = 1.78, 95% CI: 1.38–2.28) with significant interactions ( P interaction < 0.05). Conclusions There is a U‐shaped association between PIV and stage III/IV periodontitis, which suggests a potential adjunctive treatment strategy for periodontitis. Higher PIV values were found to have a stronger correlation with stage III/IV periodontitis in males and individuals with hypertension. Further prospective trials are needed to confirm the validity of our results. Plain Language Summary A U‐shaped association exists between the pan‐immune inflammation value and periodontitis in US adults, suggesting that maintaining a moderate immune inflammation response is crucial for periodontal health.