{
  "abstract": "Background/Objectives: We examined mortality associations by diabetes mellitus (DM)–periodontitis status and the incremental predictive value of composite inflammatory indices among adults with concurrent disease. Methods: We analyzed 10,632 adults from the National Health and Nutrition Examination Survey 2009–2014 linked to mortality data through 2019. Groups included neither DM nor periodontitis (NDM + NP), periodontitis alone (P), DM alone (DM), or concurrent DM and periodontitis (DM + P). Survey-weighted Cox and Fine–Gray models assessed all-cause and cardiovascular mortality. Among 978 participants with DM + P, nine survival models underwent five repeats of fivefold cross-validation to assess 5-year all-cause mortality prediction and the incremental value of eight composite inflammatory indices. Results: DM + P was associated with higher all-cause mortality than NDM + NP (HR, 1.51; 95% CI, 1.17–1.94) and P (HR, 1.31; 95% CI, 1.09–1.57). For cardiovascular mortality, DM + P was associated with higher mortality than NDM + NP (subdistribution hazard ratio [sHR], 1.51; 95% CI, 1.003–2.276), although the confidence interval only narrowly excluded 1.0. DM + P also had higher cardiovascular mortality than P (sHR, 1.55; 95% CI, 1.14–2.10). Neither outcome differed significantly between DM + P and DM. The Combined extreme gradient boosting Cox model had a concordance index and 5-year AUC of 0.754. Adding inflammatory indices did not significantly improve discrimination, prediction error, calibration, or net benefit. Observed 5-year mortality across predicted-risk tertiles was 3.7%, 7.4%, and 21.2%. Conclusions: Concurrent diabetes and periodontitis were associated with higher all-cause and cardiovascular mortality than periodontitis alone, but not with significantly higher mortality than diabetes alone. Composite inflammatory indices did not significantly improve prediction beyond clinical predictors.",
  "abstract_shown": true,
  "affiliations": [
    "Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Science, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jincheng Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Tian Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Haruhiko Kashiwazaki"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fvqwdxe7tcxw8.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208138",
  "fulltext_url": null,
  "id": "fvqwdxe7tcxw8",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8138",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3506|Oral microbiology and periodontitis research"
    ]
  ],
  "openalex": "W7223013247",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-20",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/fvqwdxe7tcxw8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208138",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8138"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Concurrent Diabetes Mellitus and Periodontitis in U.S. Adults: Mortality Associations and Machine Learning Risk Prediction",
  "title_text": "Concurrent Diabetes Mellitus and Periodontitis in U.S. Adults: Mortality Associations and Machine Learning Risk Prediction",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:01Z",
  "url": "https://research.draconitic.com/paper/fvqwdxe7tcxw8",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}