{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:35:01Z","timestamp":1790022901964,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170969"],"award-info":[{"award-number":["82170969"]}],"id":[{"id":"10.13039\/501100001809","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":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To examine the relationship between the systemic immune\u2010inflammation index (SII) and periodontitis and to investigate possible effect modifiers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data used in the present cross\u2010sectional study are from the National Health and Nutrition Examination Survey (NHANES) 2009\u20132014 (<jats:italic>N<\/jats:italic>\u00a0=\u00a010,301). The SII was calculated using the following formula: (neutrophils count \u00d7 platelet count)\/lymphocytes count. The category of periodontitis was defined by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC\/AAP) classification. We employed natural cubic spline and multivariable logistic regression analyses to evaluate the associations of the SII with periodontitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The associations between SII and periodontal health followed a J\u2010shape (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The risk of periodontitis tended to reduce with the increment of log<jats:sub>2<\/jats:sub>(SII) in participants with log<jats:sub>2<\/jats:sub>(SII)\u00a0\u2264\u00a08.66 (odds radio [OR]\u00a0=\u00a00.83; 95% CI: 0.69\u20130.999), especially among non\u2010Hispanic Whites (OR\u00a0=\u00a00.70; 95% CI: 0.52\u20130.95), and increased with the increment of log<jats:sub>2<\/jats:sub>(SII) in participants with log<jats:sub>2<\/jats:sub>(SII)\u00a0&gt;\u00a08.66 (OR\u00a0=\u00a01.19; 95% CI: 1.02\u20131.38). A similar trend was also observed between the SII and the number of sites with probing pocket depth (PPD)\u00a0\u22654\u00a0mm and clinical attachment loss (CAL)\u00a0\u2265\u00a03 or 5\u00a0mm. Furthermore, we found a significantly stronger correlation between lymphocytes and either neutrophils or platelets in individuals with log<jats:sub>2<\/jats:sub>(SII)\u00a0&gt;\u00a08.66, as opposed to those with log<jats:sub>2<\/jats:sub>(SII)\u00a0\u2264\u00a08.66.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a J\u2010shaped association between SII and periodontitis in US adults, with an inflection point of log<jats:sub>2<\/jats:sub>(SII) at 8.66, which may provide potential adjunctive treatment strategies for periodontitis with different immune response states. Further prospective trials are still required to confirm our findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.23-0260","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T11:29:46Z","timestamp":1694777386000},"page":"397-406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["J\u2010shaped association between systemic immune\u2010inflammation index and periodontitis: Results from NHANES 2009\u20132014"],"prefix":"10.1002","volume":"95","author":[{"given":"Ruoyan","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengxue","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaping","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.38"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12368"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12430"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12473"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-023-03924-y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.863640"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-0442"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14328"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-023-03018-6"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01195-0"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13230"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12313"},{"key":"e_1_2_11_14_1","first-page":"1","article-title":"National health and nutrition examination survey: sample design, 2011\u20102014","author":"Johnson CL","year":"2014","journal-title":"Vital Health Stat 2"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2197652"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2007.060264"},{"key":"e_1_2_11_17_1","unstructured":"Data analysis tutorials. Available at:https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/tutorials\/default.aspx"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13274"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41368-019-0054-1"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.20-0282"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12331"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i34.6261"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2021.02.012"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01195-0"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-022-03925-2"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12315"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034521995157"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.236.297"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9122614"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13683"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12771"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13265"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12980"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23062938"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12657"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1601114"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22179162"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0765.1989.tb00887.x"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-022-00357-8"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2008.080219"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2004.10.015"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12323"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.20-0489"}],"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/JPER.23-0260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:32:37Z","timestamp":1760873557000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/JPER.23-0260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/JPER.23-0260"],"URL":"https:\/\/doi.org\/10.1002\/jper.23-0260","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"value":"0022-3492","type":"print"},{"value":"1943-3670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]},"assertion":[{"value":"2023-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}