Meisel Peter, Kohlmann T, Nauck M, Biffar R, Kocher T
Dental Clinics, Unit of Periodontology, University Medicine, Ernst Moritz Arndt University Greifswald, Rotgerber-Str. 8, 17475, Greifswald, Germany.
Department of Community Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany.
Clin Oral Investig. 2017 Jan;21(1):183-190. doi: 10.1007/s00784-016-1775-6. Epub 2016 Mar 5.
Android and gynoid adiposity is differently involved on inflammatory responses in men or women in periodontitis and tooth loss. We tested the hypothesis whether identical waist-to-hip ratios (WHR) in men and women could abolish this disparity.
Data of 2746 participants from the Study of Health in Pomerania (SHIP) were analysed. Men and women were 1:1 matched, N = 344:344, in three age strata for waist-to-hip ratio. We determined anthropometric measures, attachment loss, tooth loss and markers of systemic inflammation.
Women matched with men by WHR had increased periodontal measures as compared to women of the general population. Nevertheless, in the matched pairs incidence risk (IRR) ratios for any tooth loss associated with elevated C-reactive protein were IRR = 2.15 (CI 1.33-3.40) and 1.04 (0.66-1.66) in men and women, respectively. Regression with tooth loss due to any cause as dependent variable showed dose dependency on C-reactive protein levels in men but not in women. The adjusted IRR associated with high C-reactive protein in men was 1.37 (CI 1.05-1.78) and 2.63 (1.58-4.38) in general and in matched subjects, respectively.
Systemic inflammation was associated with tooth loss in men but not in women even in women with wide girth. Despite worsened periodontal measures and inflammation in women matched for body shape with men, these women do not lose more teeth even when they are exposed to increased markers of systemic inflammation.
This is an attempt to disentangle the unclear relationship between obesity and periodontitis, both of them having public health relevance.
在牙周炎和牙齿缺失方面，男性和女性的腹部与臀部脂肪堆积对炎症反应的影响不同。我们检验了一个假设，即男性和女性相同的腰臀比（WHR）是否能消除这种差异。
分析了来自波美拉尼亚健康研究（SHIP）的2746名参与者的数据。男性和女性按1:1匹配，在三个年龄层中腰臀比匹配，每组N = 344人。我们测定了人体测量指标、附着丧失、牙齿缺失以及全身炎症标志物。
与总体人群中的女性相比，腰臀比与男性匹配的女性牙周指标有所增加。然而，在匹配组中，与C反应蛋白升高相关的任何牙齿缺失的发病风险（IRR）比值在男性和女性中分别为IRR = 2.15（95%CI 1.33 - 3.40）和1.04（0.66 - 1.66）。以任何原因导致的牙齿缺失为因变量的回归分析显示，男性中牙齿缺失与C反应蛋白水平呈剂量依赖性，而女性中则不然。在总体人群和匹配对象中，与高C反应蛋白相关的校正IRR在男性中分别为1.37（95%CI 1.05 - 1.78）和2.63（1.58 - 4.38）。
即使在腰围较大的女性中，全身炎症与男性的牙齿缺失相关，而与女性无关。尽管体型与男性匹配的女性牙周指标和炎症有所恶化，但即使她们暴露于全身炎症标志物增加的情况下，牙齿缺失也不会更多。
这是一次尝试，旨在理清肥胖与牙周炎之间尚不明确的关系，这两者均与公共卫生相关。
