Heitmann B L, Gamborg M
Research Unit for Dietary Studies, Institute of Preventive Medicine, Centre for Health and Society, Copenhagen University Hospital, Denmark.
Prev Med. 2008 Aug;47(2):156-60. doi: 10.1016/j.ypmed.2008.04.007. Epub 2008 Apr 29.
To examine if number of remaining teeth was associated with development of cardiovascular morbidity and mortality over 5-12 years.
Prospective observational study among 1474 men and 1458 women born 1922, 1932, 1942 or 1952 from The Danish MONICA follow up study (MONItoring trends in and determinants of CArdiovascular disease) in 1987-88 and 1993-94. Subjects were followed in Danish registers for fatal and non-fatal cardiovascular disease, coronary heart disease or stroke.
Tooth loss was strongly associated with incidence of stroke, and to a lesser extent, incidence of cardiovascular disease and coronary heart disease, during averagely 7.5 years of follow-up. Compared to those with most teeth remaining, the edentulous suffered >3-fold increased Hazard (HR) of developing stroke (HR=3.25; 95% CI: 1.48-7.14), whereas the risk of developing any cardiovascular disease was increased by 50% (HR=1.50; 95% CI: 1.02-2.19). Risk for coronary heart disease was increased by 31%, but was not significant, after the adjustment for education, age, smoking, diabetes, alcohol intake, systolic blood pressure and body mass index (HR= 1.31; 95% CI: 0.74-2.31). Associations were similar for men and women.
These findings may have implications for future prevention of cardiovascular disease in general, and of stroke in particular, because tooth loss may serve as a simple, and early means to identify high-risk individuals.
研究在5至12年期间,剩余牙齿数量是否与心血管疾病的发病率和死亡率相关。
对来自丹麦莫尼卡随访研究(监测心血管疾病的趋势和决定因素)中1922年、1932年、1942年或1952年出生的1474名男性和1458名女性进行前瞻性观察研究,研究时间为1987 - 1988年和1993 - 1994年。通过丹麦登记系统对研究对象的致命和非致命心血管疾病、冠心病或中风情况进行随访。
在平均7.5年的随访期间,牙齿缺失与中风发病率密切相关,在一定程度上也与心血管疾病和冠心病发病率相关。与牙齿保留最多的人相比,无牙者患中风的风险增加了3倍多(风险比=3.25;95%置信区间:1.48 - 7.14),而患任何心血管疾病的风险增加了50%(风险比=1.50;95%置信区间:1.02 - 2.19)。在对教育程度、年龄、吸烟、糖尿病、酒精摄入量、收缩压和体重指数进行调整后,冠心病风险增加了31%,但不显著(风险比=1.31;95%置信区间:0.74 - 2.31)。男性和女性的关联情况相似。
这些发现可能对未来心血管疾病的总体预防,尤其是中风的预防具有启示意义,因为牙齿缺失可能是识别高危个体的一种简单且早期的方法。