Chang Yoonkyung, Woo Ho Geol, Park Jin, Lee Ji Sung, Song Tae-Jin
Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Korea.
Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Korea.
Eur J Prev Cardiol. 2020 Nov;27(17):1835-1845. doi: 10.1177/2047487319886018. Epub 2019 Dec 1.
Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure. This study aims to investigate association of oral hygiene indicators with atrial fibrillation and heart failure risk in Korea.
We included 161,286 subjects from the National Health Insurance System-Health Screening Cohort who had no missing data for demographics, past history, or laboratory findings. They had no history of atrial fibrillation, heart failure, or cardiac valvular diseases. For oral hygiene indicators, presence of periodontal disease, number of tooth brushings, any reasons of dental visit, professional dental cleaning, and number of missing teeth were investigated.
During median follow-up of 10.5 years, 4911 (3.0%) cases of atrial fibrillation and 7971 (4.9%) cases of heart failure occurred. In multivariate analysis after adjusting age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, hypertension, diabetes, dyslipidemia, current smoking, renal disease, history of cancer, systolic blood pressure, blood and urine laboratory findings, frequent tooth brushing (≥3 times/day) was significantly associated with attenuated risk of atrial fibrillation (hazard ratio: 0.90, 95% confidence interval (0.83-0.98)) and heart failure (0.88, (0.82-0.94)). Professional dental cleaning was negatively (0.93, (0.88-0.99)), while number of missing teeth ≥22 was positively (1.32, (1.11-1.56)) associated with risk of heart failure.
Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent tooth brushing and professional dental cleaning may reduce risk of atrial fibrillation and heart failure.
口腔卫生状况不佳可引发短暂性菌血症和全身炎症，而全身炎症是心房颤动和心力衰竭的一个介质。本研究旨在调查韩国口腔卫生指标与心房颤动和心力衰竭风险之间的关联。
我们纳入了来自国民健康保险系统健康筛查队列的161286名受试者，这些受试者在人口统计学、既往病史或实验室检查结果方面没有缺失数据。他们没有心房颤动、心力衰竭或心脏瓣膜疾病史。对于口腔卫生指标，调查了牙周疾病的存在情况、刷牙次数、看牙的任何原因、专业牙齿清洁以及缺失牙齿的数量。
在中位随访10.5年期间，发生了4911例（3.0%）心房颤动和7971例（4.9%）心力衰竭。在调整年龄、性别、社会经济地位、规律运动、饮酒、体重指数、高血压、糖尿病、血脂异常、当前吸烟、肾脏疾病、癌症病史、收缩压、血液和尿液实验室检查结果后的多变量分析中，频繁刷牙（≥每天3次）与心房颤动风险降低显著相关（风险比：0.90，95%置信区间（0.83 - 0.98））和心力衰竭风险降低（0.88，（0.82 - 0.94））。专业牙齿清洁与心力衰竭风险呈负相关（0.93，（0.88 - 0.99）），而缺失牙齿数量≥22颗与心力衰竭风险呈正相关（1.32，（1.11 - 1.56））。
改善口腔卫生护理与心房颤动和心力衰竭风险降低相关。通过频繁刷牙和专业牙齿清洁保持更健康的口腔卫生可能会降低心房颤动和心力衰竭的风险。
