Neutrophil percentage-to-albumin ratio (NPAR), a marker of systemic inflammation, may be linked with poor periodontal health, according to a study recently published in the International Dental Journal.
High neutrophil counts and low albumin levels may be linked to moderate to severe periodontitis. Tracking these markers could help assess an individual's periodontitis risk, the authors wrote.
"We observed that NPAR was positively associated with periodontitis,” wrote the authors, led by Huan Zhou of Xi'an Jiaotong University in China (Int Dent J, December 22, 2024).
Neutrophils release reactive oxygen species during periodontitis, adding to oxidative stress and tissue degradation, while serum albumin offers antioxidant and anti-inflammatory protection.
To explore a potential link between NPAR and periodontitis, the cross-sectional study analyzed data from 10,128 adult participants from the 2009-2014 U.S. National Health and Nutrition Examination Survey. Periodontitis was classified based on the U.S. Centers for Disease Control and Prevention and the American Academy of Periodontology criteria. NPAR was calculated by dividing neutrophil percentage by serum albumin.
Weighted logistic regression examined the association between NPAR and moderate to severe periodontitis, while weighted linear regression assessed the relationship between NPAR and mean attachment loss (AL) and mean probing pocket depth (PPD), the authors wrote.
The risk of moderate to severe periodontitis increased by 12% with each standard deviation increase in NPAR. Individuals in the highest NPAR tertile were 28% more likely to have periodontitis compared to those in the lowest tertile (odds ratio [OR]tertile3vs1 = 1.28, 95% confidence interval [CI]: 1.10-1.49).
The results were also consistent across various subgroups. Additionally, NPAR showed a positive correlation with mean AL and mean PPD, they wrote.
However, the study had limitations. Its cross-sectional design prevented researchers from establishing a causal link between NPAR and periodontitis. Future multicenter prospective trials are needed to confirm any causal relationships, the authors added.
"This study highlights the importance of systemic inflammation and nutritional status for periodontal health," Zhou et al wrote.
