Darabi Zahra, Najafi Farid, Safari-Faramani Roya, Salimi Yahya
Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, 6719851351, Kermanshah, Iran.
Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, 6719851351, Kermanshah, Iran.
BMC Cardiovasc Disord. 2020 Dec 1;20(1):501. doi: 10.1186/s12872-020-01794-6.
Psychiatric disorders are significantly associated with the incidence and prevalence of cardiovascular diseases, mortality, hospital readmissionn. Oral and dental hygiene may play a role in such association. This study aimed to evaluate the controlled direct effect of psychiatric disorders on cardiovascular diseases by controlling the mediating effect of oral and dental hygiene.
The data used for this study came from the baseline phase of Ravansar Non-communicable Disease (RaNCD) cohort study. RaNCD cohort study is including a representative sample of 10,065 adults (35-65 years old) living in Ravansar, a city in the west of Iran. The marginal structural model with stabilized inverse probability weights accounted for potential confounders was used to estimate the controlled direct effect of psychiatric disorders on cardiovascular diseases. Three different models using three mediators including oral and dental hygiene behaviors, oral ulcer and lesions, and decayed, missing, and filled tooth, were used.
Psychiatric disorders increase the odds of cardiovascular diseases by 83% (OR = 1.83, CI 1.27, 2.61) and about two times (OR = 2.14, 95% CI 1.74, 2.63) when controlled for oral and dental hygiene behaviors, and oral ulcer and lesions as mediators, respectively. When decayed, missing, and filled tooth, as a mediator, was set at ≤ 8, there was no statistically significant controlled direct effect of psychiatric disorders on cardiovascular diseases (OR = 0.90, 95% CI 0.62, 1.30).
Our results suggested that psychiatric disorder was directly related to cardiovascular diseases even if it was possible to have good oral and dental hygiene. The results suggested that interventions targeting people with psychiatric disorders could reduce prevalence of the cardiovascular diseases.
精神疾病与心血管疾病的发病率、患病率、死亡率及医院再入院率显著相关。口腔及牙齿卫生可能在此关联中起作用。本研究旨在通过控制口腔及牙齿卫生的中介效应，评估精神疾病对心血管疾病的受控直接效应。
本研究使用的数据来自拉万萨尔非传染性疾病（RaNCD）队列研究的基线阶段。RaNCD队列研究纳入了伊朗西部城市拉万萨尔10,065名成年人（35 - 65岁）的代表性样本。使用具有稳定逆概率权重并考虑潜在混杂因素的边际结构模型来估计精神疾病对心血管疾病的受控直接效应。使用了三种不同模型，分别以三种中介因素为基础，包括口腔及牙齿卫生行为、口腔溃疡及病变、龋失补牙数。
当分别将口腔及牙齿卫生行为、口腔溃疡及病变作为中介因素进行控制时，精神疾病使心血管疾病的患病几率分别增加83%（OR = 1.83，CI 1.27, 2.61）和约两倍（OR = 2.14，95% CI 1.74, 2.63）。当龋失补牙数作为中介因素设定为≤8时，精神疾病对心血管疾病的受控直接效应无统计学意义（OR = 0.90，95% CI 0.62, 1.30）。
我们的结果表明，即使口腔及牙齿卫生良好，精神疾病仍与心血管疾病直接相关。结果表明，针对精神疾病患者的干预措施可降低心血管疾病的患病率。
