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However, there is currently limited direct evidence linking VOC exposure to the development of periodontitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study analyzed 1525 participants and 21 urinary VOCs in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, aiming to investigate the relationship between periodontitis risk, assessed by attachment loss (AL) and probing depth (PD) and individual VOCs using logistic regression, quantile regression, and subgroup analysis. Weighted quantile sum analysis (WQS) and subgroup analysis were utilized to evaluate whether VOC mixtures were associated with periodontitis risk. Multiple linear regression models were used to examine the association between VOC co\u2010exposure and peripheral immune cell counts. A mediation analysis was performed to evaluate whether peripheral immune cells are involved in the effect of VOC co\u2010exposure on periodontitis prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Urinary levels of 2\u2010aminothiazoline\u20104\u2010carboxylic acid, mandelic acid, and <jats:italic>N<\/jats:italic>\u2010acetyl\u2010S\u2010(4\u2010hydroxy\u20102\u2010butenyl)\u2010L\u2010cysteine were positively associated with the risk of periodontitis after adjusting for all covariates. The WQS models demonstrated a positive correlation between the mixture of VOCs and the risk of periodontitis, wherein 2\u2010aminothiazoline\u20104\u2010carboxylic acid emerged as the most important contributor. The mediation analysis suggested that monocytes may play a role in the observed association between VOC co\u2010exposure and the prevalence of periodontitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exposure to VOCs is associated with a greater prevalence of periodontitis. Monocytes' mediating role plays a crucial function in the association between the risk of periodontitis and co\u2010exposure to VOCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Volatile organic compounds (VOCs) are chemicals that evaporate quickly and are found all around us\u2014from paints to cleaning products. Understanding how these compounds affect our health is crucial, especially regarding conditions like periodontitis, a common oral chronic inflammatory disease. In our study, we looked at urine samples from 1525 people who participated in a national health survey between 2011 and 2014 to find out if there is an association between VOC exposure and the risk of developing periodontitis. We found that certain chemicals in the urine, which show VOC exposure, were indeed associated with a greater risk of the disease. We further investigated the collective impact of these VOCs on the risk of periodontitis, revealing that certain chemicals exert a more significant influence than their counterparts. Additionally, our research hints at a potential role for monocytes in the interplay between VOCs and the risk of periodontitis. Our data suggest that exposure to VOCs could be associated with a greater likelihood of periodontitis, with monocytes potentially playing a role in this relationship. This study helps us better understand the potential health impacts of daily chemical exposure and underscores the importance of investigating further how our environment affects our health.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.24-0150","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T09:01:34Z","timestamp":1734512494000},"page":"794-806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mediating role of immune cells in association between volatile organic compounds and periodontitis: NHANES 2011\u20132014"],"prefix":"10.1002","volume":"96","author":[{"given":"Wenxiu","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Orthodontics The Affiliated Stomatological Hospital of Nanjing Medical University  Nanjing China"},{"name":"State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases  Nanjing China"},{"name":"Jiangsu 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