{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:33:42Z","timestamp":1781519622544,"version":"3.54.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["#I01-BX003362 for MVP-003\/028"],"award-info":[{"award-number":["#I01-BX003362 for MVP-003\/028"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["VA ORD 24-VINCI-01"],"award-info":[{"award-number":["VA ORD 24-VINCI-01"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["K23DE026804"],"award-info":[{"award-number":["K23DE026804"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Associations between cardiometabolic comorbidities and self-reported oral health (OH) are often underexplored in large biobank datasets. While these associations are unaffected by dental care access, they could be mediated by immune responses and inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      This study assessed the associations between cardiometabolic comorbidities and self-reported OH, periodontitis, and tooth loss using the\n                      <jats:italic>International Classification of Diseases<\/jats:italic>\n                      (ICD) codes in participants from the U.S. Veterans Affairs Million Veteran Program (MVP), adjusting for immune and inflammatory covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data from 154,167 MVP participants were extracted from January 2011 to September 2021, including lifetime cardiometabolic comorbidities, self-reported OH, ICD-coded periodontitis and tooth loss, and laboratory measurements. Multivariate logistic regression analysis was used to calculate the odds ratios of cardiometabolic comorbidities for self-reported OH, periodontitis, and tooth loss, adjusting for demographic, socioeconomic, cardiovascular, and inflammatory (neutrophil and lymphocyte cell counts) risk factors. A separate dataset was used for additional sensitivity analyses, adjusting for serum levels of C-reactive protein and albumin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Complete data were analyzed for 154,167 participants (19%). Most participants (92%) were male and from European ancestry (94%). The mean age was 65.5 y (SD 11.4 y). Ten percent of participants had excellent self-reported OH. Fourteen percent had any periodontitis, and 17% had any tooth loss. Significant associations were found between tooth loss and congestive heart failure (odds ratio [OR], 1.74,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and peripheral vascular diseases (OR, 1.82, P &lt; 0.001). There were also significant associations between congestive heart failure and self-reported OH (excellent versus \u201cpoor\/fair\/good\/very good\u201d), with increasing odds as self-reported OH declined (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001 for trend). These associations remained significant even after sensitivity analyses, albeit with slight attenuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study of veterans underscores the important cardiometabolic links of self-reported poor OH and tooth loss, akin to those observed with periodontitis, even after adjusting for potential confounders related to demographics, lifestyle, and inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>Exploring cardiometabolic associations with self-reported OH, clinically diagnosed periodontitis, and tooth loss using the ICD in the Veterans Affairs Million Veteran Program, we found significant associations. These associations persisted after adjustment for inflammatory confounders. These findings emphasized the benefit of assessing OH as a vital indicator of overall cardiometabolic health in large-scale biobank studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844241291780","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T08:41:11Z","timestamp":1733301671000},"page":"457-468","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Oral Health, Inflammation, and Cardiometabolic Factors in the VA Million Veteran Program"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4723-5064","authenticated-orcid":false,"given":"Y.H.","family":"Yu","sequence":"first","affiliation":[{"name":"VA Bedford Healthcare System, Bedford, MA, USA"},{"name":"Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.M.","family":"Pridgen","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, USA"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.J.","family":"Nelson","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, USA"},{"name":"VA San Diego Healthcare System, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.R.","family":"Miller","sequence":"additional","affiliation":[{"name":"Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA"},{"name":"Center for Population Health, Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.M.","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA"},{"name":"Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA"},{"name":"Center of Biomedical and Health Research in Data Sciences (CHORDS), University of Massachusetts, Lowell, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.L.","family":"Assimes","sequence":"additional","affiliation":[{"name":"Epidemiology and Information Center for Genomics, VA Palo Alto Health Care System, Palo Alto, CA, USA"},{"name":"Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.J.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Department of Medicine, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.S.","family":"Tsao","sequence":"additional","affiliation":[{"name":"Epidemiology and Information Center for Genomics, VA Palo Alto Health Care System, Palo Alto, CA, USA"},{"name":"Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.M.","family":"Chang","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.A.","family":"Lynch","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, USA"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells12192359"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10194506"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.2287"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002941"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2013.1340011"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1241521"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btq126"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034513505621"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2007.070134"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2019.08.012"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.03.021"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.09.016"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41572"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4609-9"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01130-X"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-35553-2"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.029207"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2002.03005.x"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000052974.79428.0C"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12987"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034518814829"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2018.09.009"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192703"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12297"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192895"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.07.018"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30486"},{"key":"e_1_3_3_29_1","unstructured":"National Institutes of Health. 2021. Oral health in America: advances and challenges. Bethesda (MD): National Institutes of Health."},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.04.002"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac133"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12476"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddaa193"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2013.1340019"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000034878"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14355"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.05.013"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12335"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-021-00970-1"},{"key":"e_1_3_3_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01934-0"},{"key":"e_1_3_3_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2023.11.006"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1016373"}],"container-title":["JDR Clinical &amp; Translational Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23800844241291780","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23800844241291780","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23800844241291780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:43:39Z","timestamp":1777495419000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23800844241291780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,4]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/23800844241291780"],"URL":"https:\/\/doi.org\/10.1177\/23800844241291780","relation":{},"ISSN":["2380-0844","2380-0852"],"issn-type":[{"value":"2380-0844","type":"print"},{"value":"2380-0852","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,4]]}}}