Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, UK.
J Gerontol A Biol Sci Med Sci. 2021 Jan 18;76(2):346-351. doi: 10.1093/gerona/glaa096.
We examined the association of objective and subjective oral health markers with inflammatory, hemostatic, and cardiac biomarkers in older age.
Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising British men aged 71-92 years (n = 2,147), and the Health, Aging and Body Composition (HABC) Study comprising American men and women aged 71-80 years (n = 3,075). Oral health markers included periodontal disease, tooth count, dry mouth. Inflammatory biomarkers included C-reactive protein (CRP), interleukin-6 (IL-6) in both studies, and tissue plasminogen activator (t-PA), von Willebrand Factor (vWF), fibrin D-dimer, high-sensitivity Troponin T (hsTnT), and N-terminal pro-brain natriuretic peptide (NTproBNP) only in the BRHS.
In both studies, tooth loss, was associated with the top tertile of CRP-odds ratios (ORs) (95% confidence interval [CI]) are 1.31 (1.02-1.68) in BRHS; and 1.40 (1.13-1.75) in the HABC Study, after adjusting for confounders. In the HABC Study, cumulative (≥3) oral health problems were associated with higher levels of CRP (OR [95% CI] =1.42 [1.01-1.99]). In the BRHS, complete and partial tooth loss was associated with hemostatic factors, in particular with the top tertile of fibrin D-dimer (OR [95% CI] = 1.64 [1.16-2.30] and 1.37 [1.05-1.77], respectively). Tooth loss and periodontal disease were associated with increased levels of hsTnT.
Poor oral health in older age, particularly tooth loss, was consistently associated with some inflammatory, hemostatic, and cardiac biomarkers. Prospective studies and intervention trials could help understand better if poor oral health is causally linked to inflammatory, hemostatic, and cardiac biomarkers.
我们研究了客观和主观口腔健康指标与老年人群炎症、止血和心脏生物标志物的关联。
横断面分析基于英国区域心脏研究（BRHS），该研究纳入了 71-92 岁的英国男性（n=2147）；还基于健康、衰老和身体成分研究（HABC），该研究纳入了 71-80 岁的美国男性和女性（n=3075）。口腔健康指标包括牙周病、牙齿数量和口干。炎症生物标志物包括 C 反应蛋白（CRP）和白细胞介素-6（IL-6），这两个研究都包含；还包括组织型纤溶酶原激活物（t-PA）、血管性血友病因子（vWF）、纤维蛋白 D-二聚体、高敏肌钙蛋白 T（hsTnT）和 N 末端脑钠肽前体（NTproBNP），仅 BRHS 包含这些。
在两个研究中，牙齿缺失与 CRP 最高三分位组的比值比（OR）相关（BRHS 中为 1.31 [1.02-1.68]；HABC 研究中为 1.40 [1.13-1.75]），校正混杂因素后。在 HABC 研究中，累积（≥3）口腔健康问题与 CRP 水平升高相关（OR [95% CI] =1.42 [1.01-1.99]）。在 BRHS 中，完全和部分牙齿缺失与止血因子相关，特别是与纤维蛋白 D-二聚体最高三分位组相关（OR [95% CI] = 1.64 [1.16-2.30] 和 1.37 [1.05-1.77]）。牙齿缺失和牙周病与 hsTnT 水平升高相关。
老年人口腔健康较差，特别是牙齿缺失，与某些炎症、止血和心脏生物标志物相关。前瞻性研究和干预试验可以帮助更好地了解较差的口腔健康是否与炎症、止血和心脏生物标志物有因果关系。
