1 Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
2 Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
J Dent Res. 2018 Sep;97(10):1114-1121. doi: 10.1177/0022034518765735. Epub 2018 Mar 29.
The aim of the present study was to test the hypothesis that there is a sex difference in the association between periodontitis (PD) and a first myocardial infarction (MI). The analysis in the case-control study was based on 785 patients (147 females and 638 males) with a first MI and 792 matched controls (147 females and 645 males), screened for cardiovascular risk factors and subjected to a panoramic dental X-ray. Periodontal status was defined by alveolar bone loss and diagnosed as no PD (≥80% remaining alveolar bone), mild to moderate PD (66% to 79%), or severe PD (<66%). Logistic regression was used when analyzing PD as a risk factor for MI, adjusting for age, smoking, diabetes, education, and marital status. The mean age was 64 ± 7 y for females and 62 ± 8 y for males. Severe PD was more common in female patients than female controls (14 vs. 4%, P = 0.005), with an increased risk for severe PD among female patients with a first MI (odds ratio [OR] = 3.92, 95% confidence interval [CI] =1.53 to 10.00, P = 0.005), which remained (OR = 3.72, 95% CI = 1.24 to 11.16, P = 0.005) after adjustments. Male patients had more severe PD (7% vs. 4%; P = 0.005) than male controls and an increased risk for severe PD (OR = 1.88, 95% CI = 1.14 to 3.11, P = 0.005), but this association did not remain following adjustment (OR = 1.67, 95% CI = 0.97 to 2.84, NS). Severe PD was associated with MI in both females and males. After adjustments for relevant confounders, this association did, however, remain only in females. These data underline the importance of considering poor dental health when evaluating cardiovascular risk, especially in females.
本研究旨在检验牙周炎（PD）与首次心肌梗死（MI）之间关联存在性别差异的假设。病例对照研究的分析基于 785 名首次 MI 患者（147 名女性和 638 名男性）和 792 名匹配对照（147 名女性和 645 名男性），对心血管危险因素进行筛查，并接受全景牙科 X 光检查。牙周状况由牙槽骨丧失定义，并诊断为无 PD（≥80%的剩余牙槽骨）、轻度至中度 PD（66%至 79%）或重度 PD（<66%）。当分析 PD 作为 MI 的危险因素时，使用逻辑回归，调整年龄、吸烟、糖尿病、教育程度和婚姻状况。女性患者的平均年龄为 64±7 岁，男性患者为 62±8 岁。重度 PD 在女性患者中比女性对照更常见（14%比 4%，P=0.005），首次 MI 的女性患者中重度 PD 的风险增加（比值比[OR] = 3.92，95%置信区间[CI] = 1.53 至 10.00，P=0.005），调整后仍存在（OR=3.72，95%CI=1.24 至 11.16，P=0.005）。男性患者的 PD 比男性对照更严重（7%比 4%；P=0.005），并且重度 PD 的风险增加（OR=1.88，95%CI=1.14 至 3.11，P=0.005），但调整后这种关联不再存在（OR=1.67，95%CI=0.97 至 2.84，NS）。重度 PD 与女性和男性的 MI 均相关。然而，在调整相关混杂因素后，这种关联仅在女性中仍然存在。这些数据强调了在评估心血管风险时考虑口腔健康不佳的重要性，尤其是在女性中。
