洁牙与心血管疾病减少的关联：一项全国范围内基于人群的研究。
The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study.
机构信息
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
Am J Med. 2012 Jun;125(6):568-75. doi: 10.1016/j.amjmed.2011.10.034. Epub 2012 Apr 4.
OBJECTIVE
Poor oral hygiene has been associated with an increased risk for cardiovascular disease. However, the association between preventive dentistry and cardiovascular risk reduction has remained undetermined. The aim of this study is to investigate the association between tooth scaling and the risk of cardiovascular events by using a nationwide, population-based study and a prospective cohort design.
METHODS
Our analyses were conducted using information from a random sample of 1 million persons enrolled in the nationally representative Taiwan National Health Insurance Research Database. Exposed individuals consisted of all subjects who were aged ≥ 50 years and who received at least 1 tooth scaling in 2000. The comparison group of non-exposed persons consisted of persons who did not undergo tooth scaling and were matched to exposed individuals using propensity score matching by the time of enrollment, age, gender, history of coronary artery disease, diabetes, hypertension, and hyperlipidemia.
RESULTS
During an average follow-up period of 7 years, 10,887 subjects who had ever received tooth scaling (exposed group) and 10,989 age-, gender-, and comorbidity-matched subjects who had not received tooth scaling (non-exposed group) were enrolled. The exposed group had a lower incidence of acute myocardial infarction (1.6% vs 2.2%, P<.001), stroke (8.9% vs 10%, P=.03), and total cardiovascular events (10% vs 11.6%, P<.001) when compared with the non-exposed group. After multivariate analysis, tooth scaling was an independent factor associated with less risk of developing future myocardial infarction (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.85), stroke (HR, 0.85; 95% CI, 0.78-0.93), and total cardiovascular events (HR, 0.84; 95% CI, 0.77-0.91). Furthermore, when compared with the non-exposed group, increasing frequency of tooth scaling correlated with a higher risk reduction of acute myocardial infarction, stroke, and total cardiovascular events (P for trend<.001).
CONCLUSION
Tooth scaling was associated with a decreased risk for future cardiovascular events.
目的
较差的口腔卫生与心血管疾病风险增加相关。然而，预防牙科与心血管风险降低之间的关联仍未确定。本研究旨在通过一项全国性的基于人群的研究和前瞻性队列设计，调查洁牙与心血管事件风险之间的关系。
方法
我们的分析使用了来自全国代表性的台湾全民健康保险研究数据库中随机抽取的 100 万人的信息。暴露人群包括所有在 2000 年接受过至少一次洁牙治疗且年龄≥50 岁的患者。非暴露人群由未接受洁牙治疗的患者组成，通过在入组时、年龄、性别、冠心病史、糖尿病、高血压和高血脂的时间进行倾向评分匹配与暴露个体相匹配。
结果
在平均 7 年的随访期间，共有 10887 名曾经接受过洁牙治疗的患者（暴露组）和 10989 名年龄、性别和合并症相匹配的未接受洁牙治疗的患者（非暴露组）入组。与非暴露组相比，暴露组急性心肌梗死（1.6%比 2.2%，P<.001）、中风（8.9%比 10%，P=.03）和总心血管事件（10%比 11.6%，P<.001）的发生率较低。多变量分析后，洁牙是未来发生心肌梗死（风险比[HR]，0.69；95%置信区间[CI]，0.57-0.85）、中风（HR，0.85；95%CI，0.78-0.93）和总心血管事件（HR，0.84；95%CI，0.77-0.91）的独立危险因素。此外，与非暴露组相比，洁牙频率增加与急性心肌梗死、中风和总心血管事件的风险降低呈正相关（趋势 P<.001）。
结论
洁牙与未来心血管事件风险降低相关。
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