Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Periodontol. 2010 Nov;81(11):1622-8. doi: 10.1902/jop.2010.100058. Epub 2010 Jun 28.
Associations between periodontitis and cardiovascular and autoimmune diseases are most often assessed in patients with a particular cardiovascular or autoimmune disease. To prevent selection bias, this study assesses the existence of associations between periodontitis and cardiovascular and autoimmune diseases in patients attending a dental or periodontal clinic.
Data were collected from 1,276 randomly selected dental records from patients attending a dental (n = 588) or periodontal (n = 688) clinic. Data on the prevalence of cardiovascular and autoimmune diseases were obtained from a validated health questionnaire. Data on the presence of periodontitis were taken from patients' dental records.
In uncontrolled analyses, the prevalence of hypertension, diabetes mellitus (DM), and rheumatoid arthritis (RA) is significantly increased in patients with periodontitis. Controlled for confounding, periodontitis was associated with DM, with an odds ratio of 4 (1.03 to 15.3), in the dental clinic. DM was not associated with periodontitis in periodontal clinics. Hypertension does not seem to be associated with periodontitis when controlling for confounders. Periodontitis may be associated with RA in both clinic types.
The increased prevalence of cardiovascular and autoimmune diseases among patients with periodontitis attending dental or periodontal clinics may, at least in part, be influenced by confounding. However, the increased prevalence of DM and RA in patients with periodontitis could not be explained by confounding.
牙周炎与心血管和自身免疫性疾病之间的关联通常在患有特定心血管或自身免疫性疾病的患者中进行评估。为了避免选择偏倚,本研究评估了在牙科或牙周诊所就诊的患者中牙周炎与心血管和自身免疫性疾病之间的关联。
从参加牙科(n=588)或牙周(n=688)诊所的 1276 名随机选择的患者的牙科记录中收集数据。心血管和自身免疫性疾病的患病率数据来自经过验证的健康问卷。牙周炎的存在数据来自患者的牙科记录。
在未控制的分析中,患有牙周炎的患者中高血压、糖尿病(DM)和类风湿关节炎(RA)的患病率显著增加。在控制混杂因素后,牙周炎与 DM 相关,在牙科诊所的比值比为 4(1.03 至 15.3)。DM 与牙周炎在牙周诊所无关联。当控制混杂因素时,高血压似乎与牙周炎无关。牙周炎可能与两种类型的诊所中的 RA 相关。
在参加牙科或牙周诊所的牙周炎患者中,心血管和自身免疫性疾病的患病率增加,至少部分可能受到混杂因素的影响。然而,牙周炎患者中 DM 和 RA 的患病率增加不能用混杂因素来解释。