Lee Jae-Hong, Oh Jin-Young, Youk Tae-Mi, Jeong Seong-Nyum, Kim Young-Taek, Choi Seong-Ho
Department of Periodontology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul Department of Health Insurance Research Department of Periodontology, Ilsan Hospital, National Health Insurance Service, Goyang, Korea.
Medicine (Baltimore). 2017 Jun;96(26):e7398. doi: 10.1097/MD.0000000000007398.
The National Health Insurance Service-Health Examinee Cohort during 2002 to 2013 was used to investigate the associations between periodontal disease (PD) and the following non-communicable diseases (NCDs): hypertension, diabetes mellitus, osteoporosis, cerebral infarction, angina pectoris, myocardial infarction, and obesity.Univariate and multivariate logistic regression analyses adjusting for potential confounders during the follow-up period-including age, sex, household income, insurance status, residence area, health status, and comorbidities-were used to estimated odds ratios (ORs) with 95% confidence intervals (CIs) in order to assess the associations between PD and NCDs.We enrolled 200,026 patients with PD and 154,824 subjects with a healthy oral status. Statistically, significant associations were found between PD and the investigated NCDs except for cerebral and myocardial infarction after adjusting for sociodemographic and comorbidity factors (P < .05). In particular, obesity (OR = 1.30, 95% CI = 1.04-1.63, P = .022), osteoporosis (OR = 1.22, 95% CI = 1.18-1.27, P < .001), and angina pectoris (OR = 1.22, 95% CI = 1.17-1.27, P < .001) were significantly and positively associated with PD.This longitudinal cohort study has provided evidence that patients with PD are at increased risk of NCDs. Further studies are required to confirm the reliability of this association and elucidate the role of the inflammatory pathway in periodontitis pathogenesis as a triggering and mediating mechanism.
利用2002年至2013年期间的国民健康保险服务健康体检队列，研究牙周病（PD）与以下非传染性疾病（NCDs）之间的关联：高血压、糖尿病、骨质疏松症、脑梗死、心绞痛、心肌梗死和肥胖症。采用单因素和多因素逻辑回归分析，对随访期间的潜在混杂因素进行调整，包括年龄、性别、家庭收入、保险状况、居住地区、健康状况和合并症，以估计比值比（ORs）及95%置信区间（CIs），从而评估PD与NCDs之间的关联。我们纳入了200,026例PD患者和154,824例口腔健康状况良好的受试者。在对社会人口统计学和合并症因素进行调整后，统计学上发现PD与除脑梗死和心肌梗死外的所研究NCDs之间存在显著关联（P<0.05）。特别是，肥胖症（OR = 1.30，95% CI = 1.04 - 1.63，P = 0.022）、骨质疏松症（OR = 1.22，95% CI = 1.18 - 1.27，P < 0.001）和心绞痛（OR = 1.22，95% CI = 1.17 - 1.27，P < 0.001）与PD显著正相关。这项纵向队列研究提供了证据，表明PD患者患NCDs的风险增加。需要进一步研究来证实这种关联的可靠性，并阐明炎症途径在牙周炎发病机制中作为触发和介导机制的作用。
