Haas Alex N, Rösing Cassiano K, Oppermann Rui V, Albandar Jasim M, Susin Cristiano
Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
J Periodontol. 2009 Sep;80(9):1380-7. doi: 10.1902/jop.2009.090082.
The aim of the present study was to evaluate the association among menopause, hormone replacement therapy (HRT), and periodontal attachment loss (PAL).
Three hundred twenty-eight women (40 to 69 years old) who participated in a previous oral survey in South Brazil were included. Women who reported not having their monthly menstrual cycles for >or=12 months were classified as postmenopausal. Postmenopausal women were categorized according to HRT. Women with >or=30% teeth with PAL >or=5 mm were classified as having periodontitis. The data were analyzed using a multivariable logistic regression model and adjusted for age, smoking, socioeconomic status, and dental care.
The prevalence of periodontitis was significantly greater among postmenopausal women not using HRT (HRT-) than among premenopausal women (64.4% versus 46.3%; P = 0.005). Similarly, the multivariable analysis demonstrated a significantly higher chance of having periodontitis in postmenopausal HRT- women than in premenopausal women (odds ratio [OR], 2.1; 95% confidence interval [CI]: 1.1 to 4.0). In contrast, no significant differences were observed in the prevalence of periodontitis between postmenopausal women using HRT (HRT+) and premenopausal women (48.8% versus 46.3%; P = 0.77). After adjusting for cofactors, postmenopausal HRT+ women did not have a greater likelihood of having periodontitis than premenopausal women (OR, 1.2; 95% CI: 0.6 to 2.5). No significant differences in tooth loss were observed among the study groups after adjusting for confounders.
Postmenopausal HRT- women had a greater chance of having periodontitis than premenopausal women. In contrast, postmenopausal HRT+ women and premenopausal women had similar periodontal status. HRT may have a beneficial effect on periodontal health.
本研究旨在评估绝经、激素替代疗法（HRT）与牙周附着丧失（PAL）之间的关联。
纳入了328名年龄在40至69岁之间、曾参与巴西南部先前口腔调查的女性。报告月经周期停止≥12个月的女性被归类为绝经后女性。绝经后女性根据是否使用HRT进行分类。PAL≥5mm的牙齿比例≥30%的女性被归类为患有牙周炎。使用多变量逻辑回归模型对数据进行分析，并对年龄、吸烟、社会经济地位和口腔保健情况进行校正。
未使用HRT的绝经后女性（HRT-）中牙周炎的患病率显著高于绝经前女性（64.4%对46.3%；P = 0.005）。同样，多变量分析显示，绝经后HRT-女性患牙周炎的几率显著高于绝经前女性（比值比[OR]为2.1；95%置信区间[CI]：1.1至4.0）。相比之下，使用HRT的绝经后女性（HRT+）与绝经前女性的牙周炎患病率无显著差异（48.8%对46.3%；P = 0.77）。在对协变量进行校正后，绝经后HRT+女性患牙周炎的可能性并不高于绝经前女性（OR为1.2；95%CI：0.6至2.5）。在对混杂因素进行校正后，各研究组之间的牙齿缺失情况无显著差异。
绝经后HRT-女性患牙周炎的几率高于绝经前女性。相比之下，绝经后HRT+女性和绝经前女性的牙周状况相似。HRT可能对牙周健康有有益影响。
