Wu T, Trevisan M, Genco R J, Dorn J P, Falkner K L, Sempos C T
Department of Social and Preventive Medicine, State University of New York at Buffalo, 3435 Main St, Buffalo, NY 14214.
Arch Intern Med. 2000 Oct 9;160(18):2749-55. doi: 10.1001/archinte.160.18.2749.
Periodontal disease has been found to be a potential risk factor for coronary heart disease. However, its association with cerebrovascular accidents (CVAs) is much less studied.
This study examines the association between periodontal disease and CVA. The study cohort comprises 9962 adults aged 25 to 74 years who participated in the First National Health and Nutrition Examination Survey and its follow-up study. Baseline periodontal status was categorized into (1) no periodontal disease, (2) gingivitis, (3) periodontitis, and (4) edentulousness. All CVAs (International Classification of Diseases, Ninth Revision [ICD-9], codes 430-438) were ascertained by hospital records for nonfatal events and death certificates for fatal events. The first CVA, nonfatal or fatal, was used to define incidence. Relative risks were estimated by hazard ratios from the Cox proportional hazard model with adjustment for several demographic variables and well-established cardiovascular risk factors. Weights were used to generate risk estimates.
Periodontitis is a significant risk factor for total CVA and, in particular, nonhemorrhagic stroke (ICD-9, 433-434 and 436-438). Compared with no periodontal disease, the relative risks (95% confidence intervals) for incident nonhemorrhagic stroke were 1.24 (0.74-2.08) for gingivitis, 2.11 (1.30-3.42) for periodontitis, and 1.41 (0.96-2.06) for edentulousness. For total CVA, the results were 1.02 (0.70-1.48) for gingivitis, 1.66 (1.15-2.39) for periodontitis, and 1.23 (0.91-1.66) for edentulousness. Increased relative risks for total CVA and nonhemorrhagic stroke associated with periodontitis were also seen in white men, white women, and African Americans. Similar results were found for fatal CVA.
Periodontal disease is an important risk factor for total CVA and, in particular, nonhemorrhagic stroke.
牙周病已被发现是冠心病的一个潜在危险因素。然而，其与脑血管意外（CVA）的关联研究较少。
本研究探讨牙周病与CVA之间的关联。研究队列包括9962名年龄在25至74岁之间的成年人，他们参与了第一次全国健康和营养检查调查及其随访研究。基线牙周状况分为：（1）无牙周病，（2）牙龈炎，（3）牙周炎，（4）无牙。所有CVA（国际疾病分类第九版[ICD - 9]，编码430 - 438）通过非致命事件的医院记录和致命事件的死亡证明来确定。首次发生的CVA，无论非致命或致命，均用于定义发病率。通过Cox比例风险模型的风险比估计相对风险，并对几个人口统计学变量和已确定的心血管危险因素进行调整。使用权重来生成风险估计值。
牙周炎是总CVA尤其是非出血性中风（ICD - 9，433 - 434和436 - 438）的一个重要危险因素。与无牙周病相比，牙龈炎患者发生非出血性中风的相对风险（95%置信区间）为1.24（0.74 - 2.08），牙周炎患者为2.11（1.30 - 3.42），无牙患者为1.41（0.96 - 2.06）。对于总CVA，牙龈炎患者的结果为1.02（0.70 - 1.48），牙周炎患者为1.66（1.15 - 2.39），无牙患者为1.23（0.91 - 1.66）。在白人男性、白人女性和非裔美国人中，也观察到与牙周炎相关的总CVA和非出血性中风的相对风险增加。致命性CVA也有类似结果。
牙周病是总CVA尤其是非出血性中风的一个重要危险因素。
