Zhang Qi, Li Zhixin, Wang Chunxiao, Shen Tao, Yang Yang, Chotivichien Saipin, Wang Linhong
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Chinese Field Epidemiology Training Program (CFETP), Chinese Center for Disease Control and Prevention, Beijing, China.
Glob Health Action. 2014 Jul 8;7:24503. doi: 10.3402/gha.v7.24503. eCollection 2014.
Although the interrelationship between poor oral health and chronic diseases is well established, few related studies are available in China. In this study, the prevalence of severe periodontitis and its association with chronic diseases among adults in China have been explored.
During China's 2010 Chronic Disease and Risk Factor Surveillance (CCDRFS) survey among adults aged 18 and older, 3 out of 162 surveillance points and the entire sample from each point (600×3=1,800 subjects) were selected as pilot study sites in which oral examination was performed. Basic demographic information, chronic diseases status, and results of oral examination were collected from 2010 CCDRFS data. A standard oral examination was conducted by trained staff. Periodontitis was defined as moderate (4-5 mm pockets) or severe (≥6 mm pockets). Chronic disease status was determined by using standard methods and criteria. Multivariate logistic analysis was used to identify the independent association of various factors with severe periodontitis.
Of 1,800 subjects, 1,728 subjects (96%) provided complete information. The prevalence of severe periodontitis was 1.9% (32/1,728) (95% CI=1.2-2.5). In multivariate model, participants with diabetes were 2.4 times (OR=2.4, 95% CI=1.1-5.6) more likely to have severe periodontitis. Being male was significantly associated with severe periodontitis (OR=3.5, 95% CI=1.6-7.7). Living in a rural area was related to an increased chance of having severe periodontitis (OR=2.1, 95% CI=1.0- 4.9). Attainment of at least 6 years of education was inversely associated with severe periodontitis (OR=0.3, 95% CI=0.1-0.8).
According to this pilot project, prevalence of severe periodontitis was low. Control measures should be particularly emphasized for high-risk groups such as less educated people (<6 years of education), people living in rural areas, men, and diabetes patients. Population-based studies, including oral examination by trained staff, are feasible and should be done in order to understand the burden of periodontitis and to provide an effective response to this key oral health issue.
尽管口腔健康状况不佳与慢性病之间的相互关系已得到充分证实,但中国相关研究较少。本研究旨在探讨中国成年人中重度牙周炎的患病率及其与慢性病的关联。
在中国2010年针对18岁及以上成年人开展的慢性病与危险因素监测(CCDRFS)调查中,从162个监测点中选取3个点,并选取每个点的全部样本(600×3 = 1800名受试者)作为试点研究地点进行口腔检查。从2010年CCDRFS数据中收集基本人口统计学信息、慢性病状况和口腔检查结果。由经过培训的工作人员进行标准口腔检查。牙周炎定义为中度(牙周袋4 - 5毫米)或重度(牙周袋≥6毫米)。慢性病状况通过标准方法和标准确定。采用多因素逻辑回归分析确定各因素与重度牙周炎的独立关联。
1800名受试者中,1728名受试者(96%)提供了完整信息。重度牙周炎的患病率为1.9%(32/1728)(95%置信区间 = 1.2 - 2.5)。在多因素模型中,糖尿病患者患重度牙周炎的可能性是正常人的2.4倍(比值比 = 2.4,95%置信区间 = 1.1 - 5.6)。男性与重度牙周炎显著相关(比值比 = 3.5,95%置信区间 = 1.6 - 7.7)。生活在农村地区患重度牙周炎的几率增加(比值比 = 2.1,95%置信区间 = 1.0 - 4.9)。受教育年限至少6年与重度牙周炎呈负相关(比值比 = 0.3,95%置信区间 = 0.1 - 0.8)。
根据该试点项目,重度牙周炎患病率较低。应特别强调针对教育程度较低(<6年教育)、农村居民、男性和糖尿病患者等高风险人群的控制措施。包括由经过培训的工作人员进行口腔检查在内的基于人群的研究是可行的,为了解牙周炎负担并有效应对这一关键口腔健康问题应开展此类研究。