Genetically determined histo-blood group phenotypes and periodontal traits: The HUNT Study

Background

The ability of bacteria to adhere to surfaces in the oral cavity is crucial for both the initiation and progression of periodontitis. Histo-blood group antigens, including the ABO and Lewis glycan antigens, whose expression is further influenced by secretor status, serve as attachment sites for a range of pathogens. Therefore, we aimed to investigate the relationships between genetically determined histo-blood group phenotypes and prevalence of periodontitis and radiographic alveolar bone loss in a general Norwegian population.

Methods

The study included 4706 participants from the HUNT4 Oral Health Study. Histo-blood group phenotypes were inferred from genetic variants in the ABO, FUT2, and FUT3 genes. Severe periodontitis was defined as stage III or IV according to the 2017 AAP/EFP classification. An alveolar bone loss score was calculated based on radiographic assessment of bone loss in permanent teeth.

Results

Among non-secretors, the A and B groups showed a 38 and 69% higher prevalence of severe periodontitis, respectively, than the O group [prevalence ratios (95% confidence intervals): 1.38 (1.03–1.86) and 1.69 (1.05–2.71)]. These associations were consistent when using the alveolar bone loss score as the outcome. Additionally, blood group B (vs. O), as well as Le(a+b-) and Le(a-b+) [vs. Le(a-b-)] were associated with increased alveolar bone loss scores.

Conclusions

We found evidence of higher prevalence of severe periodontitis and greater alveolar bone loss among individuals with blood group A or B among non-secretors. Individuals with Le(a+b-) and Le(a-b+) also exhibited greater alveolar bone loss. The histo-blood group phenotypes have potential as clinical markers for identifying individuals at high risk of periodontitis, as phenotyping can be performed straightforwardly using serological tests.

Key messages

• Higher prevalence of severe periodontitis and greater alveolar bone loss among individuals with blood group A or B among non-secretors.

• The histo-blood group phenotypes have potential as clinical markers for identifying individuals at high risk of periodontitis.