{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:19:44Z","timestamp":1785248384705,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periodontitis, a chronic inflammatory disease, is linked to systemic conditions such as cardiovascular and kidney disease. Serum \u03b1\u2010Klotho, an anti\u2010aging protein with anti\u2010inflammatory properties, has been associated with systemic diseases, but its role in periodontitis is unclear. This study evaluated the relationship between serum \u03b1\u2010Klotho levels and periodontitis severity while accounting for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, data from 961 participants in the National Health and Nutrition Examination Survey (NHANES) database were analyzed. Periodontitis was classified into stages (I\u2013IV) and grades (A\u2013C) using the ACES (Application of the 2018 periodontal status Classification to Epidemiological Survey data) guidelines. Serum \u03b1\u2010Klotho levels were measured via enzyme\u2010linked immunosorbent assay (ELISA). Ordinal logistic regression assessed associations between \u03b1\u2010Klotho levels and periodontitis, adjusting for confounders such as age, smoking, comorbidities, and oral hygiene. The number of lost teeth was analyzed as a secondary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In both adjusted and unadjusted regression models, no significant association was found between \u03b1\u2010Klotho levels and periodontitis. Particularly, adjusted models revealed no significant association between \u03b1\u2010Klotho levels and periodontitis stage (OR\u00a0=\u00a01.0001,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.547, 95% CI: 0.9997\u20131.0006) or grade (OR\u00a0=\u00a00.9996,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.144, 95% CI: 0.9991\u20131.0001). Age, smoking, and comorbidities significantly predicted severity. Despite a weak negative correlation between \u03b1\u2010Klotho and tooth loss (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u20130.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023), this association was no longer significant after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No significant association was found between serum \u03b1\u2010Klotho levels and periodontitis severity. Age, smoking, and comorbidities were key predictors, highlighting the multifactorial nature of periodontitis. Further longitudinal and mechanistic studies are needed to clarify whether \u03b1\u2010Klotho has a value as a biomarker of periodontal inflammation or disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70080","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:33:45Z","timestamp":1772991225000},"page":"1340-1350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between serum \u03b1\u2010Klotho levels and severity of periodontitis in a representative U.S. population"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-2104","authenticated-orcid":false,"given":"Hamoun","family":"Sabri","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION)  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5575-629X","authenticated-orcid":false,"given":"Sahar","family":"Baniameri","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8067-7133","authenticated-orcid":false,"given":"Pranav","family":"Kataria","sequence":"additional","affiliation":[{"name":"Department of Periodontics University of Connecticut Health Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5427-8220","authenticated-orcid":false,"given":"Hend","family":"Abulatifa","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8362-3208","authenticated-orcid":false,"given":"Parham","family":"Hazrati","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-1799","authenticated-orcid":false,"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-7317","authenticated-orcid":false,"given":"Muhammad H. A.","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"SalehMHA SabriH.Dose\u2010dependent association of systemic comorbidities with periodontitis severity: a large population cross\u2010sectional study. 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