Association between stress hyperglycemia ratio and periodontitis among diabetes: evidence from National Health and Nutrition Examination Survey 2009-2014.

OBJECTIVE: The relationship between stress-induced hyperglycemia and periodontitis is still unclear. The objective of this study was to identify the potential association between stress hyperglycemia ratio (SHR) and periodontitis among diabetes. METHOD AND MATERIALS: A cross-sectional analysis was performed based on diabetic patients who had complete periodontal examination from National Health and Nutrition Examination Survey (NHANES) 2009-2014. Severity of periodontitis was defined by CDC/AAP criteria. The moderate/severe degree was considered as outcome. SHR was calculated based on fasting blood glucose and glycated hemoglobin. Weighted logistic regression analysis was used to explore the association between SHR and moderate/severe periodontitis. RESULTS: There was a positive correlation between SHR and moderate/severe periodontitis (OR 2.86, 95% CI 1.21-6.79, P = .018) after adjustment of age, sex, race, education, poverty income ratio, hypertension, cardiovascular diseases, smoking status, frequency of using dental floss, bone loss around teeth, and dental caries. The odds for moderate/severe periodontitis in the highest SHR tertile was higher (OR 1.59, 95% CI 1.05-2.41, P = .030) than that in the lowest tertile in the fully adjusted model. Similar results were found in subgroups of poor glycemic control, hypertension, or cardiovascular diseases. CONCLUSION: SHR was positively associated with poor periodontal health among diabetes. (Quintessence Int 2026;57:16-23; doi: 10.3290/j.qi.b6740667).