Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
J Periodontol. 2011 Sep;82(9):1304-13. doi: 10.1902/jop.2011.100647. Epub 2011 Mar 15.
A number of epidemiologic studies were published that looked at the association between coronary heart disease (CHD) and periodontal disease. However, debate exists about whether this association is a true relationship or simply an example of an uncontrolled confounder. This retrospective cohort study examines the relationship between periodontal disease and CHD.
Digital panoramic radiographs were used to assess alveolar bone loss (ABL) using a Schei ruler. Participants consisted of Veterans Administration (VA) patients who were eligible for dental benefits and had a digital panoramic radiograph taken at the VA Medical Center, Denver, Colorado. Information on CHD and other important clinical variables were obtained from electronic medical records.
The examination of the relationship between ABL and CHD revealed a significant non-linear relationship with a threshold at ≈ 20% bone loss with a doubling of the probability ratios of CHD compared to those at 7.5% bone loss.
To our knowledge, this is the first study to demonstrate a non-linear relationship between ABL and CHD. A significant positive association between ABL and CHD was found at even low levels of bone loss between 10% and 20%.
有许多流行病学研究探讨了冠心病（CHD）和牙周病之间的关联。然而，对于这种关联是真实的关系还是仅仅是未被控制的混杂因素的一个例子，存在争议。本回顾性队列研究旨在研究牙周病与 CHD 之间的关系。
使用 Schei 标尺对数字全景 X 光片进行牙槽骨丧失（ABL）评估。参与者包括有资格获得牙科福利且在科罗拉多州丹佛市退伍军人事务医疗中心拍摄数字全景 X 光片的退伍军人事务部（VA）患者。CHD 和其他重要临床变量的信息来自电子病历。
ABL 与 CHD 之间关系的检查显示出显著的非线性关系，在 ≈ 20%骨丢失时具有阈值，与骨丢失 7.5%时相比，CHD 的概率比增加了一倍。
据我们所知，这是第一项证明 ABL 与 CHD 之间存在非线性关系的研究。在 10%至 20%之间的低水平骨丢失时，ABL 与 CHD 之间存在显著的正相关关系。
