Association between circadian syndrome and periodontitis in U.S. adults: results from NHANES 2009–2014

Nov 17, 2025Journal of diabetes and metabolic disorders

Circadian syndrome may be linked to periodontitis in U.S. adults.

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Abstract

Circadian Syndrome (CircS) was found in 59.8% of U.S. adults and is associated with 29% higher odds of periodontitis.

CircS is linked to an increased risk of periodontitis, with an odds ratio of 1.29.
Higher risks for periodontitis associated with CircS were identified in females (OR = 1.499), non-Hispanic Whites (OR = 1.352), and unmarried individuals (OR = 1.367).
Non-smokers (OR = 1.308) and individuals with low education (OR = 1.880) also showed elevated risk for periodontitis in relation to CircS.
Sensitivity analysis confirmed the association's robustness with an odds ratio of 1.22.

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PURPOSE: To investigate the association between Circadian Syndrome (CircS)-a metabolic syndrome extension incorporating circadian disruption-and periodontitis in U.S. adults, and to identify high-risk subgroups for targeted prevention.

METHODS: We analyzed 5,343 U.S. adults from NHANES 2009-2014. Periodontitis was defined by probing depth and clinical attachment level; CircS required ≥ 4 of 7 components (waist circumference, triglycerides, HDL-C, BP, fasting glucose, sleep ≤ 6 h, PHQ-9 ≥ 5). Weighted multivariable logistic regression, subgroup analyses and Propensity Score Matching (PSM) were used.

RESULTS: CircS prevalence was 59.8%. After adjusting for sociodemographics and lifestyle, CircS was associated with 29% higher odds of periodontitis (OR = 1.29, 95%CI:1.08-1.53). Subgroups with elevated risk included females (OR = 1.499), non-Hispanic Whites (OR = 1.352), unmarried individuals (OR = 1.367), non-smokers (OR = 1.308), and those with low education (OR = 1.880). PSM sensitivity analysis confirmed robustness (OR = 1.22, = 0.048). p

CONCLUSION: CircS independently predicts periodontitis risk, underscoring circadian-metabolic dysregulation as a shared pathway for oral-systemic disease. Integration of circadian health screening into diabetes/metabolic care may enhance periodontitis prevention, particularly in high-risk subgroups.

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Association between circadian syndrome and periodontitis in U.S. adults: results from NHANES 2009–2014

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