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社区牙周指数与粪便血红蛋白浓度(一种结直肠肿瘤指标)之间的关系

Relationship between Community Periodontal Index and Fecal Hemoglobin Concentration, an Indicator for Colorectal Neoplasm.

作者信息

Yen A M-F, Lai H, Fann J C-Y, Chiu S Y-H, Chen S L-S

机构信息

School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

QC Dental Clinic, Taipei, Taiwan Department of Dentistry, National Yang-Ming University, Taipei, Taiwan School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

J Dent Res. 2014 Aug;93(8):760-6. doi: 10.1177/0022034514539976. Epub 2014 Jun 17.

Abstract

Periodontal disease and colorectal cancer have inflammatory processes in common. It is therefore worthwhile to investigate whether there is an association between periodontal probing depth and fecal hemoglobin concentration (FHbC), an indicator of colorectal neoplasms, in 40- to 44-year-old Taiwanese. We enrolled a total of 6,214 attendees aged 40 to 44 yr who were participating in a community-based integrated screening program and who received both periodontal and FHbC examinations between 2003 and 2008. A proportional odds logistic regression model was used to estimate the odds ratios of different FHbC levels in treating an increased level of community periodontal index (CPI) measuring periodontal probing depth as ordinary data from 0 to 4. Periodontal probing depth with the order of CPI was in parallel with an increase in the mean values of FHbC: 21.3 ± 156.3, 26.0 ± 167.7, 27.2 ± 151.1, and 39.5 ± 255.7 ng/mL for CPI 0, CPI 1, CPI 2, and CPI 3/4, respectively. The log-FHbC varied across the categories of CPI (p = .0078). After adjusting for age, sex, education level, smoking, alcohol intake, exercise, body mass index, and intake of meat and vegetables, subjects with positive fecal immunochemical test results (FHbC ≥ 100 ng/mL) had a 33% higher risk of deteriorating to severe CPI than did those within the normal range of fecal immunochemical test (FHbC < 100 ng/mL) (adjusted odds ratio = 1.33, 95% confidence interval: 1.03-1.73). A positive association was demonstrated between FHbC and periodontal probing depth assessed by CPI among 6,214 Taiwanese aged 40 to 44 yr who participated in a community-based integrated health screening program. These results could have significant implications for early identification of high-risk individuals, as those with deep periodontal pockets should be advised to undergo screening for colorectal cancer at a younger age than commonly recommended.

摘要

牙周病和结直肠癌存在共同的炎症过程。因此,有必要调查40至44岁台湾人群中牙周探诊深度与粪便血红蛋白浓度(FHbC,结直肠肿瘤的一个指标)之间是否存在关联。我们共纳入了6214名年龄在40至44岁的参与者,他们参加了一项基于社区的综合筛查项目,并在2003年至2008年期间接受了牙周和FHbC检查。使用比例优势逻辑回归模型来估计在将测量牙周探诊深度的社区牙周指数(CPI)水平从0到4作为普通数据处理时,不同FHbC水平的优势比。CPI顺序的牙周探诊深度与FHbC平均值的增加呈平行关系:CPI 0、CPI 1、CPI 2和CPI 3/4时,FHbC平均值分别为21.3±156.3、26.0±167.7、27.2±151.1和39.5±255.7 ng/mL。log-FHbC在CPI类别间存在差异(p = 0.0078)。在调整年龄、性别、教育水平、吸烟、饮酒、运动、体重指数以及肉类和蔬菜摄入量后,粪便免疫化学检测结果呈阳性(FHbC≥100 ng/mL)的受试者相比粪便免疫化学检测结果在正常范围内(FHbC < 100 ng/mL)的受试者,病情恶化为严重CPI的风险高33%(调整后的优势比 = 1.33,95%置信区间:1.03 - 1.73)。在参与基于社区的综合健康筛查项目的6214名40至44岁台湾人群中,证实了FHbC与通过CPI评估的牙周探诊深度之间存在正相关。这些结果对于高危个体的早期识别可能具有重要意义,因为对于牙周袋较深的个体,应建议其在比通常推荐的年龄更小的时候接受结直肠癌筛查。

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