1 Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
2 OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Dent Res. 2019 May;98(5):534-540. doi: 10.1177/0022034519833630. Epub 2019 Mar 8.
Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC) and by FEV/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.
虽然已知它们具有共同的病理生理过程，但牙周炎和慢性阻塞性肺疾病（COPD）之间的关系尚未完全阐明。本研究的目的是检验以下假设，即在考虑吸烟因素的情况下，牙周炎与 COPD 的发病风险增加有关。在一项基于人群的 5 年随访队列研究中进行了分析，该研究纳入了 900 名无 COPD 的、年龄在 60 岁及以上的、居住在社区的日本成年人（年龄：68.8 ± 6.3[均值 ± 标准差]，46.0%为男性），这些人至少有 1 颗牙齿。根据基线时牙周炎严重程度（无/轻度、中度和重度）将参与者分为 3 组。通过固定的 1 秒用力呼气量（FEV）/用力肺活量（FVC）<0.7 的比值和 FEV/FVC 低于正常下限来确定 COPD 的肺活量测定值。使用泊松回归计算牙周炎严重程度与 COPD 发病风险的相对风险（RR）。还计算了人群归因分数（PAF）。随访期间，22 名（2.4%）受试者发生了 COPD。与无/轻度牙周炎患者相比，严重牙周炎患者发生 COPD 的风险显著增加（RR=3.55；95%置信区间[CI]，1.18 至 10.67），但无/轻度和中度组之间无显著差异（RR=1.48；95%CI，0.56 至 3.90）。在调整了包括吸烟强度在内的潜在混杂因素后，严重牙周炎与 COPD 风险之间的关系仍然显著（RR=3.51；95%CI，1.15 至 10.74）。同样，牙周炎严重程度与 COPD 风险呈正相关（趋势 P 值=0.043）。牙周炎导致 COPD 的 PAF 为 22.6%。这些数据突出了牙周炎作为 COPD 危险因素的潜在重要性。
