Department of Operative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
J Clin Periodontol. 2018 Mar;45(3):303-310. doi: 10.1111/jcpe.12856. Epub 2018 Jan 11.
To investigate whether coeliac disease (CD) was associated with periodontitis among a nationally representative sample of US adults.
The National Health and Nutrition Examination Survey (NHANES) 2009-2012 enrolled 6,661 subjects with full-mouth periodontal examination and serological testing for antitissue transglutaminase (tTg) and antiendomysial (EMA) antibodies. CD was defined as (i) self-reported physician diagnosis while on a gluten-free diet; or (ii) tTg levels >10.0 U/ml and positive EMA results. Positive serology without self-reported diagnosis was defined as undiagnosed CD (UdxCD). Periodontitis was defined according to the CDC/AAP definition. Multivariable linear and logistic models were used to regress the mean probing depth (PD) or attachment loss (AL) outcomes across CD categories (none, diagnosed and undiagnosed).
The prevalence of moderate/severe periodontitis and diagnosed/undiagnosed CD was 40% and 0.74%, respectively. Mean AL was lower among those with CD although results were not statistically significant (p = .67). The odds of periodontitis among individuals with diagnosed and undiagnosed CD were: 0.5(0.22, 1.16) and 0.62(0.1, 3.75), respectively. Mean PD levels among those without CD or with diagnosed or undiagnosed CD were 1.49 ± 0.02, 1.36 ± 0.11 and 1.31 ± 0.11 (p = .03).
CD is associated with modestly lower levels of mean PD but was not associated with mean AL or periodontitis. Larger studies are necessary to enhance precision and strengthen conclusions.
调查在全美具有代表性的成年人样本中，乳糜泻（CD）是否与牙周炎相关。
NHANES 2009-2012 调查纳入了 6661 名受试者，对其进行全口牙周检查和抗组织转谷氨酰胺酶（tTg）和抗内肌膜（EMA）抗体的血清学检测。CD 的定义为：（i）经医生诊断后接受无麸质饮食；或（ii）tTg 水平>10.0 U/ml 且 EMA 结果阳性。无自我报告诊断的阳性血清学结果定义为未确诊的 CD（UdxCD）。根据疾病控制与预防中心/美国牙周病学会的定义，牙周炎被定义为。采用多元线性和逻辑回归模型，根据 CD 类别（无、确诊和未确诊）对平均探诊深度（PD）或附着丧失（AL）结果进行回归。
中重度牙周炎和确诊/未确诊 CD 的患病率分别为 40%和 0.74%。尽管结果无统计学意义（p=0.67），但 CD 患者的平均 AL 较低。确诊和未确诊 CD 患者发生牙周炎的几率分别为 0.5（0.22，1.16）和 0.62（0.1，3.75）。无 CD 或确诊 CD 或未确诊 CD 的患者的平均 PD 水平分别为 1.49±0.02、1.36±0.11 和 1.31±0.11（p=0.03）。
CD 与平均 PD 水平略有降低相关，但与平均 AL 或牙周炎无关。需要更大规模的研究来提高精度并增强结论。
