Hyman Jeffrey J, Reid Britt C
Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, Bethesda, MD 20892-6401, USA.
J Periodontol. 2004 Jan;75(1):9-15. doi: 10.1902/jop.2004.75.1.9.
Cigarette smoking is a significant risk factor for both chronic obstructive pulmonary disease (COPD) and periodontal disease. The goal of this study was to better understand the role of smoking in a possible relationship between periodontal disease and COPD.
The study population consisted of 7,625 participants in the Third National Health and Nutrition Examination Survey (NHANES III) during 1988-1994 who were aged 30 years or older when examined and who received a spirometric examination. The data analysis employed logistic regression models and accounted for the complex sampling design used in NHANES III.
After adjustment for potential confounders, there was no statistically significant association between periodontal disease and COPD among former or non-smokers. Current smokers with > or = 4 mm mean loss of attachment had an odds ratio of 3.71 (95% confidence interval: 1.74, 7.89).
These results suggest that cigarette smoking may be a cofactor in the relationship between periodontal disease and chronic obstructive pulmonary disease. The key role played by smoking in the etiology of both periodontal disease and chronic obstructive pulmonary disease suggests that much of the observed increase in risk may actually reflect the exposure to smoking. Additional research into smoking-related effect modification is needed to clarify the role of periodontal disease in the etiology of smoking-related systemic diseases.
吸烟是慢性阻塞性肺疾病(COPD)和牙周病的重要危险因素。本研究的目的是更好地了解吸烟在牙周病与COPD可能存在的关系中所起的作用。
研究人群包括1988 - 1994年第三次全国健康和营养检查调查(NHANES III)中的7625名参与者,这些参与者在接受检查时年龄在30岁及以上,并接受了肺活量测定检查。数据分析采用逻辑回归模型,并考虑了NHANES III中使用的复杂抽样设计。
在对潜在混杂因素进行调整后,既往吸烟者或非吸烟者中,牙周病与COPD之间无统计学显著关联。平均附着丧失≥4mm的当前吸烟者的比值比为3.71(95%置信区间:1.74, 7.89)。
这些结果表明,吸烟可能是牙周病与慢性阻塞性肺疾病之间关系中的一个辅助因素。吸烟在牙周病和慢性阻塞性肺疾病病因中所起的关键作用表明,观察到的风险增加可能实际上反映了吸烟暴露情况。需要对吸烟相关的效应修饰进行更多研究,以阐明牙周病在吸烟相关全身性疾病病因中的作用。