Iron In Periodontitis

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tom hennessy

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Dec 9, 2021, 3:47:49 AM12/9/21
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High serum iron markers are associated with periodontitis in postmenopausal women: a population-based study (NHANES III)
Susilena Arouche Costa 1, Cecilia Claudia Costa Ribeiro 2, Ana Regina Oliveira Moreira 3, Soraia de Fátima Carvalho Souza 4
J Clin Periodontol
. 2021 Dec 8. doi: 10.1111/jcpe.13580.\

Abstract
Aim: To investigate the association between increased serum markers of iron (ferritin and transferrin saturation) and the severity and extent of periodontitis in postmenopausal women.

Methods: Data from 982 postmenopausal women participating in NHANES III were analyzed. Exposures were high ferritin (≥ 300 μg/mL) and transferrin saturation (≥45%). The primary outcome was moderate/severe periodontitis defined according to Centers for Disease Control and Prevention and the American Academy of Periodontology. The extent of periodontitis was also assessed as outcome: proportion of sites affected by clinical attachment loss ≥4 mm and probing depth ≥ 4 mm. Crude and adjusted Prevalence Ratio (PR) and Mean Ratio (MR) were estimated using Poisson Regression.

Results: The prevalence of moderate/severe periodontitis was 27.56%. High ferritin was associated with moderate/severe periodontitis in the crude (PR 1.55, p = 0.018) and in the final adjusted model (PR 1.53, p = 0.008). High ferritin and transferrin saturation levels were associated with a higher proportion of sites with clinical attachment loss ≥4 mm (p < 0.05).

Conclusion: The increasing serum iron markers seem to contribute to periodontitis severity and extent in postmenopausal women.

PMID: 34879443 DOI: 10.1111/jcpe.13580

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Steven Bornfeld

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Dec 9, 2021, 10:46:56 AM12/9/21
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1) Increase in ferritin has potential causes other than diet
2) Association does not indicate causation.

John Forkosh

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Dec 10, 2021, 3:12:58 AM12/10/21
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Steven Bornfeld <denta...@earthlink.net> wrote:
> On 12/9/2021 3:47 AM, tom hennessy wrote:
>> High serum iron markers are associated with periodontitis in
>> postmenopausal women: a population-based study (NHANES III)
>> Susilena Arouche Costa 1, Cecilia Claudia Costa Ribeiro 2,
>> Ana Regina Oliveira Moreira 3, Soraia de F??tima Carvalho Souza 4
>> J Clin Periodontol . 2021 Dec 8. doi: 10.1111/jcpe.13580.\
>>
>> Abstract
>> Aim: To investigate the association between increased serum markers
>> of iron (ferritin and transferrin saturation) and the severity and
>> extent of periodontitis in postmenopausal women.
>>
>> Methods: Data from 982 postmenopausal women participating in
>> NHANES III were analyzed. Exposures were high ferritin (300 g/mL)
>> and transferrin saturation (45%). The primary outcome was
>> moderate/severe periodontitis defined according to Centers for
>> Disease Control and Prevention and the American Academy of
>> Periodontology. The extent of periodontitis was also assessed
>> as outcome: proportion of sites affected by clinical attachment
>> loss 4mm and probing depth 4mm. Crude and adjusted Prevalence
>> Ratio (PR) and Mean Ratio (MR) were estimated using Poisson
>> Regression.
>>
>> Results: The prevalence of moderate/severe periodontitis was 27.56%.
>> High ferritin was associated with moderate/severe periodontitis in
>> the crude (PR 1.55, p = 0.018) and in the final adjusted model
>> (PR 1.53, p = 0.008). High ferritin and transferrin saturation levels
>> were associated with a higher proportion of sites with clinical
>> attachment loss 4mm (p < 0.05).
>>
>> Conclusion: The increasing serum iron markers seem to contribute
>> to periodontitis severity and extent in postmenopausal women.
>>
>> PMID: 34879443 DOI: 10.1111/jcpe.13580
>> Tom
>
>
> 1) Increase in ferritin has potential causes other than diet
> 2) Association does not indicate causation.

Actually, re item 2, it kind of does. Not direct A-->B causation,
but indirect C-->A && C-->B, i.e., a (so far undetected) common
cause for both A and B. The typical paradigmatic example given
is the 100% correlation between the monsoon season in India,
which always begins several weeks after flowers bloom in upstate
New York. So NY flowers cause India's monsoons? No, but the Earth's
orbit around the Sun causes both. So the point here would be to
suggest that maybe (emphasize maybe) whatever (besides diet, as per
your item 1) is causing ferritin increase might also be responsible
for the periodontitis increase. At least, might be worth looking at.
--
John Forkosh ( mailto: j...@f.com where j=john and f=forkosh )

Steven Bornfeld

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Dec 10, 2021, 10:41:21 PM12/10/21
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On 12/10/2021 3:12 AM, John Forkosh wrote:
>>
>> 1) Increase in ferritin has potential causes other than diet
>> 2) Association does not indicate causation.
>
> Actually, re item 2, it kind of does. Not direct A-->B causation,
> but indirect C-->A && C-->B, i.e., a (so far undetected) common
> cause for both A and B. The typical paradigmatic example given
> is the 100% correlation between the monsoon season in India,
> which always begins several weeks after flowers bloom in upstate
> New York. So NY flowers cause India's monsoons? No, but the Earth's
> orbit around the Sun causes both. So the point here would be to
> suggest that maybe (emphasize maybe) whatever (besides diet, as per
> your item 1) is causing ferritin increase might also be responsible
> for the periodontitis increase. At least, might be worth looking at.
>

Hi John, hope all is well.
You are correct of course. I might better have said that correlation
does not NECESSARILY mean causation (or not the direction of causation.
A direct cause of high ferritin might be hemochromatosis.
Hemochromatosis is often undiagnosed. My late wife had hemochromatosis,
she definitely did NOT have periodontitis. Has that study been done?
Apparently yes!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195524/

John Forkosh

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Dec 12, 2021, 11:18:01 AM12/12/21
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Steven Bornfeld <denta...@earthlink.net> wrote:
> John Forkosh wrote:
>>>
>>> 1) Increase in ferritin has potential causes other than diet
>>> 2) Association does not indicate causation.
>>
>> Actually, re item 2, it kind of does. Not direct A-->B causation,
>> but indirect C-->A && C-->B, i.e., a (so far undetected) common
>> cause for both A and B. The typical paradigmatic example given
>> is the 100% correlation between the monsoon season in India,
>> which always begins several weeks after flowers bloom in upstate
>> New York. So NY flowers cause India's monsoons? No, but the Earth's
>> orbit around the Sun causes both. So the point here would be to
>> suggest that maybe (emphasize maybe) whatever (besides diet, as per
>> your item 1) is causing ferritin increase might also be responsible
>> for the periodontitis increase. At least, might be worth looking at.
>>
>
> Hi John, hope all is well.
So far, so good (quoting the captain of the Titanic).

> You are correct of course.
I didn't mean (and wouldn't have posted) to correct you, per se.
Just wanted to suggest that the op's observation might possibly
be of some value.

> I might better have said that correlation
> does not NECESSARILY mean causation (or not the direction of causation.
> A direct cause of high ferritin might be hemochromatosis.
> Hemochromatosis is often undiagnosed. My late wife had hemochromatosis,
> she definitely did NOT have periodontitis. Has that study been done?
> Apparently yes!
>
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195524/
Thanks for the link. Too many multi-syllable words I wasn't
familiar with to make a whole lot of sense out of it, but that final
paragraph preceding _Results_, "Therefore, we hypothesized that..."
seems to suggest (as far as I could infer) that they're taking the
correlation seriously, i.e., as meaning something more than
coincidence.
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