Famili Pouran, Cauley Jane A, Greenspan Susan L
Department of Periodontics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
J Urol. 2007 Mar;177(3):921-4. doi: 10.1016/j.juro.2006.10.067.
We tested the hypothesis that men undergoing androgen deprivation therapy as treatment for prostate cancer are at greater risk for periodontitis and tooth loss.
A total of 81 men with a mean age of 68.5 years who had prostate cancer were consecutively recruited among 325 enrolled in an academic osteoporosis study. Of these men 68 were eligible to participate in the research. The prevalence of periodontal disease in 41 men with prostate cancer undergoing androgen deprivation for a mean of 1.5 years was compared to that in 27 with prostate cancer not undergoing androgen deprivation, who served as controls. The prevalence of periodontal disease was examined in relation to bone mineral density in men with prostate cancer with and without androgen deprivation therapy. A periodontist (PF) blinded to androgen deprivation status recorded probing depth, clinical attachment level, bleeding, plaque scores, gingival recession, missing teeth and calculus. Logistic regression models were used to test the association between androgen deprivation therapy and periodontal disease. Linear regression models were used to assess the association between periodontal disease and bone mineral density in the 2 groups with prostate cancer (treated/untreated). We adjusted for variables known to influence periodontal disease, including patient age, race, smoking and periodontal disease history.
The prevalence of periodontal disease was 80.5% in men on androgen deprivation therapy compared with 3.7% in those not on androgen deprivation therapy (OR 3.33, 95% CI 1.07-10.35). Men on androgen deprivation therapy had significantly greater probing depth and higher plaque scores (p<0.001 and <0.09, respectively). A total of 81 men (76.9%) completed bone mineral density examinations. There was no relationship between bone mineral density and periodontal disease.
Men with prostate cancer undergoing androgen deprivation therapy were more likely to have periodontal disease than men not on androgen deprivation therapy. If confirmed in larger studies, this observation could have important public health implications, given the increasing use of androgen deprivation therapy to treat prostate cancer.
我们检验了这样一个假设，即接受雄激素剥夺疗法治疗前列腺癌的男性患牙周炎和牙齿脱落的风险更高。
在一项学术性骨质疏松研究招募的325名男性中，连续招募了81名平均年龄为68.5岁的前列腺癌男性患者。其中68名男性符合参与研究的条件。将41名接受平均1.5年雄激素剥夺治疗的前列腺癌男性的牙周疾病患病率与27名未接受雄激素剥夺治疗的前列腺癌男性（作为对照）的患病率进行比较。研究了接受和未接受雄激素剥夺疗法的前列腺癌男性的牙周疾病患病率与骨密度之间的关系。一位对雄激素剥夺状态不知情的牙周病医生（PF）记录了探诊深度、临床附着水平、出血情况、菌斑评分、牙龈退缩、缺失牙和牙结石情况。使用逻辑回归模型来检验雄激素剥夺疗法与牙周疾病之间的关联。使用线性回归模型来评估前列腺癌两组（接受治疗/未接受治疗）中牙周疾病与骨密度之间的关联。我们对已知会影响牙周疾病的变量进行了调整，包括患者年龄、种族、吸烟情况和牙周疾病史。
接受雄激素剥夺疗法的男性中牙周疾病患病率为80.5%，而未接受雄激素剥夺疗法的男性中患病率为3.7%（比值比3.33，95%置信区间1.07 - 10.35）。接受雄激素剥夺疗法的男性探诊深度显著更深，菌斑评分更高（分别为p<0.001和<0.09）。共有81名男性（76.9%）完成了骨密度检查。骨密度与牙周疾病之间没有关系。
接受雄激素剥夺疗法治疗前列腺癌的男性比未接受雄激素剥夺疗法的男性更易患牙周疾病。鉴于雄激素剥夺疗法在治疗前列腺癌中的使用日益增加，如果在更大规模的研究中得到证实，这一观察结果可能具有重要的公共卫生意义。
