Department of Medical Sciences, Uppsala University, Sweden
Department of Medical Sciences, Uppsala University, Sweden.
Eur J Prev Cardiol. 2015 Jun;22(6):771-8. doi: 10.1177/2047487314530660. Epub 2014 Apr 10.
There are reported links between periodontal disease (PD) and cardiovascular (CV) risk but data are lacking, especially from populations with established coronary heart disease (CHD). This study describes self-reported indicators of PD and associations with CV risk factors in a global stable CHD population.
A total of 15,828 participants in the global STABILITY trial underwent a physical examination, blood sampling, and completed a lifestyle questionnaire. They reported remaining number of teeth (none, 1-14, 15-20, 21-25 or 26-32 (all)) and frequency of gum bleeding (never/rarely, sometimes, often or always). Adjusted linear and logistic regression models assessed associations between tooth loss, gum bleeding, and socioeconomic and CV risk factors. A total of 40.9% of participants had <15 remaining teeth; 16.4% had no teeth; and 25.6% reported gum bleeding with large differences in prevalence among countries, regions and ethnic groups. Less tooth loss was associated with lower levels of glucose, low-density lipoprotein (LDL) cholesterol, systolic blood pressure, waist circumference and hs-CRP; higher estimated glomerular filtration rate; decreased odds for diabetes and smoking, and increased odds for higher education, alcohol consumption and work stress. Gum bleeding was associated with higher LDL cholesterol and systolic blood pressure; decreased odds for smoking, but increased odds for higher education, alcohol consumption and stress.
Self-reported indicators of PD were common in this chronic CHD population and were associated with an increasing socioeconomic and CV risk factor burden. However, causality between self-reported PD and CV risk and outcome needs further investigation.
有报道称牙周病（PD）与心血管（CV）风险之间存在关联，但数据不足，尤其是在已确诊冠心病（CHD）的人群中。本研究描述了在全球稳定 CHD 人群中自我报告的 PD 指标与 CV 危险因素之间的关系。
全球 STABILITY 试验共纳入 15828 名参与者，进行了体格检查、血液采样和生活方式问卷调查。他们报告了剩余牙齿的数量（无牙、1-14 颗、15-20 颗、21-25 颗或 26-32 颗（全部））和牙龈出血的频率（从不/很少、有时、经常或总是）。调整后的线性和逻辑回归模型评估了牙齿缺失、牙龈出血与社会经济和 CV 危险因素之间的关系。共有 40.9%的参与者剩余牙齿数<15；16.4%的参与者无牙；25.6%的参与者报告牙龈出血，且不同国家、地区和种族群体的患病率存在较大差异。牙齿缺失越少，血糖、低密度脂蛋白（LDL）胆固醇、收缩压、腰围和高敏 C 反应蛋白水平越低；估算肾小球滤过率越高；糖尿病和吸烟的可能性越低，受教育程度越高、饮酒和工作压力越大的可能性越高。牙龈出血与 LDL 胆固醇和收缩压升高有关；与吸烟的可能性降低有关，但与受教育程度更高、饮酒和压力更大的可能性增加有关。
在本慢性 CHD 人群中，自我报告的 PD 指标很常见，与不断增加的社会经济和 CV 危险因素负担有关。然而，自我报告的 PD 与 CV 风险和结局之间的因果关系需要进一步研究。
