Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI.
J Periodontol. 2020 Oct;91(10):1245-1255. doi: 10.1002/JPER.19-0593. Epub 2020 Mar 5.
To investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis.
A total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age- and gender-matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression.
The top three most common medications were angiotensin-converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid-lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally, intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity-dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively.
There was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity-dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis.
本研究旨在调查患有或不患有牙周炎的老年患者全身用药的频率，以及药物使用与牙周炎严重程度之间的可能关联。
共纳入 1221 名患者，其中 608 名患有广泛性中重度牙周炎（牙周炎组），613 名年龄和性别相匹配的牙周健康者（健康组）。记录全身状况、药物使用和牙周状况。采用非条件 logistic 回归比较药物使用频率（%）。
最常使用的前 3 种药物为血管紧张素转换酶（ACE）抑制剂（17.9%）、抗抑郁药（17.8%）和降脂药（16.5%）。ACE 抑制剂和抗抑郁药在牙周炎组的使用频率均明显高于健康对照组（21.5%比 14.4%，比值比 [OR] = 1.64）（21.1%比 14.5%，OR = 1.57）（P < 0.01）。此外，牙周炎组口服降糖药、钙通道阻滞剂（CCB）、胰岛素和利尿剂的使用频率也明显高于健康对照组（OR = 2.49、2.32、2.08 和 1.79）（P < 0.05）。几种药物的使用频率与疾病严重程度有关，比较广泛重度牙周炎与中度牙周炎和健康组：口服降糖药（17.4%比 16.8%比 8.0%）、CCB（14.8%比 14.4%比 8.0%）和抗惊厥药（13.4%比 7.7%比 6.4%），OR 分别为 2.43、1.99 和 2.28（重度牙周炎与健康组相比）。
牙周炎患者全身用药与心血管疾病和糖尿病相关的频率明显较高。药物使用频率与疾病严重程度呈正相关。本研究为系统疾病与牙周炎之间可能存在的关系提供了间接证据。
