Scannapieco F A, Ho A W
Department of Oral Biology, University at Buffalo, State University of New York, 14214, USA.
J Periodontol. 2001 Jan;72(1):50-6. doi: 10.1902/jop.2001.72.1.50.
Associations between poor oral health and chronic lung disease have recently been reported. The present study evaluated these potential associations by analyzing data from the National Health and Nutrition Examination Survey III (NHANES III), which documents the general health and nutritional status of randomly selected United States subjects from 1988 to 1994.
This cross-sectional, retrospective study of the NHANES III database included a study population of 13,792 subjects > or = 20 years of age with at least 6 natural teeth. A history of bronchitis and/or emphysema was recorded from the medical questionnaire, and a dichotomized variable combined those with either chronic bronchitis and/or emphysema, together considered as chronic obstructive pulmonary disease (COPD). Subject lung function was estimated by calculating the ratio of forced expiratory volume (FEV) after 1 second (FEV1)/forced vital capacity (FVC). Oral health status was assessed from the DMFS/T index (summary of cumulative caries experience), gingival bleeding, gingival recession, gingival probing depth, and periodontal attachment level. Unweighted analyses were used for initial examination of the data, and a weighted analysis was performed in a final logistic regression model adjusting for age, gender, race and ethnicity, education, income, frequency of dental visits, diabetes mellitus, smoking, and alcohol use.
The mean age of all subjects was 44.4 +/- 17.8 years (mean +/- SD): COPD = 51.2 +/- 17.9 years and subjects without COPD = 43.9 +/- 17.7 years. Subjects with a history of COPD had more periodontal attachment loss than subjects without COPD (1.48 +/- 1.35 mm versus 1.17 +/- 1.09 mm, P = 0.0001). Subjects with mean attachment loss (MAL) > or = 3.0 mm had a higher risk of COPD than those having MAL < 3.0 mm (odds ratio, 1.45; 95% CI, 1.02 to 2.05). A trend was noted in that lung function appeared to diminish with increasing periodontal attachment loss.
The findings of the present analysis support recently published reports that suggest an association between periodontal disease and COPD.
近期有报道称口腔健康状况不佳与慢性肺部疾病之间存在关联。本研究通过分析美国国家健康与营养检查调查III（NHANES III）的数据来评估这些潜在关联，该调查记录了1988年至1994年随机抽取的美国受试者的总体健康和营养状况。
这项对NHANES III数据库的横断面回顾性研究纳入了13792名年龄大于或等于20岁且至少有6颗天然牙的受试者。从医疗问卷中记录支气管炎和/或肺气肿病史，并将患有慢性支气管炎和/或肺气肿的受试者合并为一个二分变量，统称为慢性阻塞性肺疾病（COPD）。通过计算1秒用力呼气量（FEV）与用力肺活量（FVC）的比值来估计受试者的肺功能。从DMFS/T指数（累积龋齿经历总结）、牙龈出血、牙龈退缩、牙龈探诊深度和牙周附着水平评估口腔健康状况。对数据进行初步检查时采用非加权分析，并在最终的逻辑回归模型中进行加权分析，该模型对年龄、性别、种族和民族、教育程度、收入、牙科就诊频率、糖尿病、吸烟和饮酒进行了调整。
所有受试者的平均年龄为44.4±17.8岁（平均值±标准差）：COPD患者为51.2±17.9岁，无COPD的受试者为43.9±17.7岁。有COPD病史的受试者比无COPD的受试者有更多的牙周附着丧失（1.48±1.35毫米对1.17±1.09毫米，P = 0.0001）。平均附着丧失（MAL）大于或等于3.0毫米的受试者患COPD的风险高于MAL小于3.0毫米的受试者（比值比，1.45；95%可信区间，1.02至2.05）。观察到一种趋势，即肺功能似乎随着牙周附着丧失的增加而下降。
本分析结果支持最近发表的报告，即牙周病与COPD之间存在关联。
