Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands.
Medical Statistics and Decision Making, Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands.
J Gerontol A Biol Sci Med Sci. 2021 Jun 14;76(7):1309-1315. doi: 10.1093/gerona/glaa223.
Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.
We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001-2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.
Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = -0.091; 95% confidence interval [CI] = -0.174 to -0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = -0.059; 95% CI = -0.087 to -0.031) and mediated 20.3% of the total association.
Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
牙周感染的全身影响可能会增加中枢神经炎症的风险，从而加重认知障碍。本研究旨在探讨全身炎症因子是否介导牙周炎症与认知功能之间的可能关联。
我们对参加了 2001-2002 年全国健康和营养调查（NHANES）的 766 名年龄≥60 岁且完成了牙周和认知检查的参与者进行了横断面分析。我们使用多变量线性回归来研究牙周健康与数字符号替换测试（DSST）所衡量的认知功能之间的总体关联。探诊出血（BOP）和牙周炎表面面积（PISA）分别用于评估牙周炎症活动度和负担。中介分析用于测试 BOP/PISA 通过 C 反应蛋白、白细胞（WBC）计数和纤维蛋白原对 DSST 的间接效应。
调整人口统计学因素和慢性疾病后，牙周健康状况较好的参与者的 DSST 得分高于牙周健康状况较差的参与者。就炎症活动而言，WBC 计数在 BOP 与 DSST 之间的关联中起完全中介作用（β=-0.091；95%置信区间[CI]：-0.174 至-0.008），并介导了总关联的 27.5%。就炎症负担而言，WBC 计数在 PISA 与 DSST 之间的关联中起部分中介作用（β=-0.059；95%CI：-0.087 至-0.031），并介导了总关联的 20.3%。
我们的研究表明，全身炎症因子可能在牙周炎症与美国老年人群认知功能之间的关联中起中介作用。
