Study finds marginal association between periodontitis severity and total PSA levels

A new study published in the Journal of Periodontology showed that periodontitis severity and total prostate-specific antigen (PSA) levels are marginally correlated, and there is no discernible mediation by calcium levels, osteoporosis, arthritis, or C-reactive protein (CRP).

Systemic inflammation may be influenced by periodontitis, and new research indicates that the severity of the condition may be correlated with higher levels of prostate-specific antigen, which suggests a potential oral–prostate inflammatory connection with diagnostic implications. Thus, this study determined if the relationship between prostate-specific antigen and periodontitis is direct or mediated by other systemic disorders.

A total of 12,874 subjects from three data cycles (2001–2002, 2003–2004, and 2009–2010) of the National Health and Nutrition Examination Survey (NHANES) were analyzed for demographics, systemic conditions, periodontal health indicators, PSA, and C-reactive protein levels in 3020 male participants. Tooth loss, the 2012 Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) severity, the 2017 European Federation of Periodontology (EFP)/AAP Workshop stage, and a composite outcome of stage and open pocket percentage were used to determine the severity of periodontitis.

The relationship between total PSA levels and periodontitis severity (measured by staging and open pocket percentage) was investigated using multilevel stepwise regression analysis. Potential mediators influencing PSA levels, including calcium levels, osteoporosis, arthritis, and CRP, were investigated by mediation analysis. The probability of higher PSA levels depending on various thresholds (>2 ng/mL, >2.5 ng/mL, >4 ng/mL) was also evaluated using logistic regression models. The research also included information from a comprehensive follow-up survey of 58 patients from the 2003–2004 cycle.

The study found a weak correlation (p < 0.05) between total PSA levels and the composite result. Logistic analysis, however, was unable to find any meaningful correlations between increased PSA levels and periodontitis markers. calcium levels, osteoporosis, arthritis, and CRP did not substantially mitigate this connection, according to mediation analysis. The patients who were edentulous were more likely to need further prostate treatment, according to the follow-up.

Overall, PSA levels and periodontitis did not significantly correlate, according to the study. However, a correlation between total PSA levels and tooth loss was discovered. Calcium levels, osteoporosis, arthritis, or CRP did not significantly mediate the relationship between total PSA levels and the combined effects of staging and open pocket percentage.

Source:

Saleh, M. H. A., Kalani, K., Sabri, H., Alhazmi, S., Nair, D., Morgan, T. M., Wang, H.-L., & Decker, A. M. (2025). Association between periodontitis severity and prostate-specific antigen levels using the NHANES data. Journal of Periodontology, 96(10), 1113–1125. https://doi.org/10.1002/JPER.24-0561