{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:10:17Z","timestamp":1786493417043,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["T32 HL007779"],"award-info":[{"award-number":["T32 HL007779"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although periodontitis and oral microbiota are linked to cardiometabolic diseases (CMD), it is unclear if they similarly predict CMD mortality. We compared the predictive ability of salivary microbiota and periodontal disease measures for CMD mortality in the National Health and Nutrition Examination Survey (NHANES).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included 5,037 adults aged \u226530 years (mean age [\u00b1\u00a0standard deviation (SD)]: 48[\u00b1\u00a014]; 50% male) from the 2009\u20132010 and 2011\u20132012 NHANES cycles. We used 16S rRNA sequencing data from saliva to operationalize microbial composition and diversity. We calculated the relative abundance log\u2010ratio of\n                      <jats:italic>Treponema<\/jats:italic>\n                      (linked with periodontal disease) to\n                      <jats:italic>Corynebacterium<\/jats:italic>\n                      (linked with periodontal health) to compute the Microbial Indicator of Periodontitis (MIP). Interproximal periodontal probing depth and clinical attachment loss were measured from periodontal examinations. Mortality was ascertained through 2019. Survey\u2010weighted Cox models regressed mortality rates on MIP, microbial diversity, and periodontal measures to estimate hazard ratios and 95% confidence intervals (HR [95% CI]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 8.8 median follow\u2010up years, there were 81 CMD and 267 all\u2010cause deaths. After multivariable adjustment, MIP was associated with increased CMD mortality risk (HR per 1\u2010SD: 2.10 [1.30\u20133.38]). Neither microbial diversity nor periodontitis measures were associated with CMD mortality. MIP was associated with periodontitis in multivariable modeling (risk ratio per 1\u2010SD: 1.29 [1.22\u20131.39]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In a nationally representative cohort, greater baseline salivary\n                      <jats:italic>Treponema<\/jats:italic>\n                      to\n                      <jats:italic>Corynebacterium<\/jats:italic>\n                      ratio predicted increased CMD mortality risk, while microbial diversity metrics and periodontal parameters were not significantly associated with CMD mortality. Longitudinal studies that further contextualize the oral microbiota are warranted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Bacteria in the mouth that cause gum disease are linked to cardiometabolic diseases (e.g., diabetes, cardiovascular disease, kidney disease). However, it is not well understood if bacteria of the mouth can predict the risk of death due to cardiometabolic diseases. We used data from a nationwide survey of US adults to explore whether bacteria from saliva, collected from a single time point, are associated with the future risk of cardiometabolic disease death. We found that people with higher levels of gum disease bacteria were more likely to die from cardiometabolic diseases. Future studies are needed to better understand the role of gum disease bacteria in the development of cardiometabolic diseases and the risk of death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.11395","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:45:28Z","timestamp":1760107528000},"page":"552-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Salivary microbiota and clinical periodontal measures predicting cardiometabolic disease mortality: A nationwide survey"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9655-7628","authenticated-orcid":false,"given":"Hamdi S.","family":"Adam","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0956-9821","authenticated-orcid":false,"given":"Weihua","family":"Guan","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data Science University of Minnesota School of Public Health  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5998-4724","authenticated-orcid":false,"given":"Abigail J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-1811","authenticated-orcid":false,"given":"Sanaz","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2208-5397","authenticated-orcid":false,"given":"Charlene","family":"Goh","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-483X","authenticated-orcid":false,"given":"James S.","family":"Pankow","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3429-0379","authenticated-orcid":false,"given":"Ryan T.","family":"Demmer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota School of Public Health  Minneapolis Minnesota USA"},{"name":"Division of Epidemiology Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Centers for Disease Control and Prevention.National Diabetes Statistics Report.Centers for Disease Control and Prevention. 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