一种 BMI 与中国人广泛性侵袭性牙周炎风险之间呈新颖 U 型关系：一项横断面研究。
A novel U-shaped relationship between BMI and risk of generalized aggressive periodontitis in Chinese: A cross-sectional study.
机构信息
Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.
出版信息
J Periodontol. 2019 Jan;90(1):82-89. doi: 10.1002/JPER.18-0064. Epub 2018 Aug 29.
BACKGROUND
Association between BMI and periodontitis were controversial. A study indicated that not only overweight or obesity but also underweight was correlated with generalized aggressive periodontitis (GAgP). However, the exact relationship between BMI and GAgP and the optimal BMI value for the lowest risk of GAgP remain unknown.
OBJECTIVE
To explore the exact relationship between BMI and GAgP risk, periodontal status and WBC (white blood cell) count and find the optimal BMI value associated with the lowest risk, periodontal status and lowest WBC of GAgP in Chinese.
METHODS
300 GAgP patients and 133 healthy controls were recruited. Height and weight of participants were accurately measured to calculate BMI value. Clinical periodontal parameters, including probing depth (PD), attachment loss (AL), and bleeding index (BI) were recorded. WBC was obtained from routine blood examination. Smooth curve fitting and segmented regression model were used to analyze the threshold effect between BMI and variables. The shape of the curve was used to describe the relationships between BMI and GAgP.
RESULTS
U-shaped relationships between BMI and risk of GAgP, AL, and WBC count in GAgP patients were observed. The optimal value of BMI for the lowest risk of GAgP and lowest WBC count was 22 kg/m . The risk of GAgP increased by 39% in patients per unit increase of BMI when BMI ranged from 22 to 28 kg/m (adjusted OR = 1.39, 95% CI: 1.17, 1.67) and increased by 18% per unit decrease of BMI when BMI ranged from 22 to 18 kg/m (adjusted OR = 0.82, 95% CI: 0.69, 0.97). The count of WBC increased by 1.12 × 10 /L in patients per unit increase of BMI when BMI ranged from 22 to 28 kg/m (adjusted β = 0.12, 95% CI: 0.01, 0.23) and increased by 0.2 × 10 /L per unit decrease of BMI when BMI ranged from 22 to18 kg/m (adjusted β = -0.2, 95% CI: -0.35, -0.04).
CONCLUSION
U-shaped relationships exist between BMI and risk of GAgP, AL, and WBC count in patients with GAgP among Chinese aged below 36 years old with their BMI range from 18 to 28 kg/m ; the optimal BMI value for lowest odds ratio and lowest WBC count of GAgP was 22 kg/m .
背景
BMI 与牙周炎之间的关系存在争议。一项研究表明，不仅超重或肥胖，而且体重过轻也与广泛性侵袭性牙周炎（GAgP）有关。然而，BMI 与 GAgP 的确切关系以及 BMI 值与 GAgP 风险最低相关的最佳值仍不清楚。
目的
探讨 BMI 与 GAgP 风险、牙周状况和白细胞计数（WBC）之间的确切关系，并找到与中国 GAgP 患者牙周状况最低、WBC 最低和 GAgP 风险最低相关的最佳 BMI 值。
方法
招募了 300 名 GAgP 患者和 133 名健康对照者。准确测量参与者的身高和体重，计算 BMI 值。记录临床牙周参数，包括探诊深度（PD）、附着丧失（AL）和出血指数（BI）。从常规血液检查中获得 WBC。使用平滑曲线拟合和分段回归模型分析 BMI 与变量之间的阈值效应。使用曲线的形状来描述 BMI 与 GAgP 之间的关系。
结果
观察到 BMI 与 GAgP 患者的 GAgP 风险、AL 和 WBC 计数之间呈 U 形关系。BMI 为 22 kg/m 时，GAgP 风险最低和 WBC 计数最低的最佳 BMI 值为 22 kg/m 。当 BMI 范围在 22 至 28 kg/m 时，BMI 每增加一个单位，GAgP 患者的风险增加 39%（调整后的 OR=1.39，95%CI：1.17，1.67），当 BMI 范围在 22 至 18 kg/m 时，BMI 每减少一个单位，GAgP 患者的风险降低 18%（调整后的 OR=0.82，95%CI：0.69，0.97）。当 BMI 范围在 22 至 28 kg/m 时，BMI 每增加一个单位，GAgP 患者的 WBC 计数增加 1.12×10 /L（调整后的β=0.12，95%CI：0.01，0.23），当 BMI 范围在 22 至 18 kg/m 时，BMI 每减少一个单位，GAgP 患者的 WBC 计数增加 0.2×10 /L（调整后的β=-0.2，95%CI：-0.35，-0.04）。
结论
在中国年龄在 36 岁以下 BMI 范围在 18 至 28 kg/m 的 GAgP 患者中，BMI 与 GAgP 风险、AL 和 WBC 计数之间存在 U 形关系；BMI 值与 GAgP 最低比值和最低 WBC 计数相关的最佳 BMI 值为 22 kg/m 。
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