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波兰人牙齿状况与急性心肌梗死风险之间的关联:病例对照研究

The Association Between Dental Status and Risk of Acute Myocardial Infarction Among Poles: Case-control Study.

作者信息

Górski Bartłomiej, Nargiełło Ewa, Grabowska Ewa, Opolski Grzegorz, Górska Renata

机构信息

Department of Periodontology and Oral Mucous Membrane Diseases, Medical University of Warsaw, Poland.

First Department of Cardiology, Medical University of Warsaw, Poland.

出版信息

Adv Clin Exp Med. 2016 Sep-Oct;25(5):861-870. doi: 10.17219/acem/58866.

Abstract

BACKGROUND

Results of scientific research on the effects of periodontitis on the incidence of myocardial infarction (MI) are ambiguous.

OBJECTIVES

The aim of this study was to investigate the association of the severity and extent of periodontitis with acute MI in Poles.

MATERIAL AND METHODS

This case-control study included 134 cases hospitalized with acute MI under the age of 70 years and 155 controls drawn from the general population with no MI history. Sociodemographic, cardiologic and periodontal variables were assessed. Three periodontal indicators were evaluated: (1) the severity of periodontitis classified in accordance with Page and Eke definition, (2) the extent of periodontitis determined on the basis of the percentage of sites with CAL ≥ 3 mm (Arbes Index) and (3) tooth loss (> 10 teeth). In a logistic regression model, the association of periodontal parameters with MI occurrence was evaluated after adjusting for well-known cardiovascular risk factors.

RESULTS

The extent of periodontitis was significantly associated with the risk of acute MI even after adjusting for age, sex, tobacco smoking, hypertension, diabetes, BMI, education and income (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.1 to 5.2; p = 0.0203). However, the severity of periodontitis was associated with MI after adjusting for age and sex (OR = 2.0; 95% CI = 1.2-3.5; p = 0.0109), but not after adjusting for the other above-mentioned risk factors. The association between the number of lost teeth and acute MI was significant after adjusting for age, sex, tobacco smoking, arterial hypertension and diabetes mellitus (OR = 2.1; 95% CI = 1.2-5.9; p = 0.0151).

CONCLUSIONS

This study proves the positive association between periodontitis and acute MI in Poles. This association seems to be stronger with regard to the extent rather than to the severity of periodontitis.

摘要

背景

关于牙周炎对心肌梗死(MI)发病率影响的科学研究结果尚不明确。

目的

本研究旨在调查波兰人群中牙周炎的严重程度和范围与急性心肌梗死之间的关联。

材料与方法

本病例对照研究纳入了134例70岁以下因急性心肌梗死住院的患者以及155例来自无心肌梗死病史普通人群的对照。评估了社会人口统计学、心脏病学和牙周变量。评估了三个牙周指标:(1)根据佩奇和埃克的定义分类的牙周炎严重程度,(2)根据附着丧失(CAL)≥3mm的部位百分比确定的牙周炎范围(阿贝斯指数),以及(3)牙齿缺失(>10颗牙)。在逻辑回归模型中,在对已知的心血管危险因素进行调整后,评估牙周参数与心肌梗死发生之间的关联。

结果

即使在对年龄、性别、吸烟、高血压、糖尿病、体重指数、教育程度和收入进行调整后,牙周炎的范围仍与急性心肌梗死风险显著相关(比值比[OR]=2.4;95%置信区间[CI]=1.1至5.2;p=0.0203)。然而,在对年龄和性别进行调整后,牙周炎的严重程度与心肌梗死相关(OR=2.0;95%CI=1.2 - 3.5;p=0.0109),但在对上述其他危险因素进行调整后则不相关。在对年龄、性别、吸烟、动脉高血压和糖尿病进行调整后,牙齿缺失数量与急性心肌梗死之间的关联显著(OR=2.1;95%CI=1.2 - 5.9;p=0.0151)。

结论

本研究证明了波兰人群中牙周炎与急性心肌梗死之间存在正相关。这种关联在牙周炎的范围方面似乎比严重程度方面更强。

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