Association between serum HE4 and poor periodontal health in adult women

OBJECTIVES: The aim of this study is to explore the association between serum human epididymal protein (HE4) levels and poor periodontal health. MATERIALS AND METHODS: Data used in our study from the National Health and Nutrition Examination Survey (NHANES) 2001–2002 and Gene Expression Omnibus database (GSE10334 and GSE16134). Periodontitis category was defined by the 2017 classification scheme based on clinical periodontal parameters. Univariate and multivariate logistic regression analyses were used to explore the relationship between serum HE4 levels and the risk of periodontitis. GSEA analysis was performed to investigate the function of HE4. RESULTS: A total of 1715 adult women over the age of 30 were included in our study. Compared with the lowest tertile, individuals in the highest tertile of HE4 levels were more likely to be Stage III/IV periodontitis (OR(tertile3vs1) = 2.35, 95% CI: 1.35–4.21). The association was still significant in populations who were less than 60 years old, non-Hispanic white, high school graduate, 1.3 < PI ≤ 3.5, non-smoker, current smoker, non-obese, obese, and who had not diabetes mellitus or had not hypertension. In addition, HE4 expression was upregulated in diseased gingival tissues and involved in cell proliferation and immunity. CONCLUSIONS: Serum HE4 is positively associated with poor periodontal health in adult women. CLINICAL RELEVANCE: Patients with high serum HE4 levels are more likely to have Stage III/IV periodontitis. HE4 has the potential to be used as a biomarker to predict the severity of periodontitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00784-023-05111-1.