Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, Brazil.
Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
Clin Oral Investig. 2021 Oct;25(10):5855-5865. doi: 10.1007/s00784-021-03891-y. Epub 2021 Mar 24.
To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors.
Using a population-based sample study (n = 405) of Brazilian adolescents (17-18 years old), direct and mediation pathways triggered by "Socioeconomic Status," "Adiposity," Smoking, and "Blood Pressure" were modelled for the association between the "Systemic Circulating Inflammatory Burden of CVD Risk" (IL-1β, IL-6, IL-8, TNF-α) and the "Initial Periodontitis" (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes "Gingivitis" (visible plaque; BoP); "Moderate Periodontitis" (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition).
Higher "Systemic Circulating Inflammatory Burden of CVD Risk" was directly associated with higher "Initial Periodontitis" (standardized coefficient [SC] = 0.178, P value < 0.001). Lower "Socioeconomic Status" (SC = - 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the "Initial Periodontitis", mediated by "Systemic Circulating Inflammatory Burden of CVD Risk". Sensitivity analysis showed a dose-response relationship between "Systemic Circulating Inflammatory Burden of CVD Risk" and "Moderate Periodontitis" (SC = 0.323, P value = 0.021).
"Systemic Circulating Inflammatory Burden of CVD Risk" appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking.
The association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.
分析心血管疾病 (CVD) 风险的系统性炎症负担与青少年牙周炎之间的关联，包括由其共同危险因素引发的中介途径。
使用巴西青少年（17-18 岁）的基于人群的样本研究（n=405），使用结构方程模型对“心血管疾病风险的系统性循环炎症负担”（IL-1β、IL-6、IL-8、TNF-α）与“初始牙周炎”（探诊出血（BoP）、探诊深度 (PD) ≥ 4 毫米、临床附着丧失 (CAL) ≥ 4 毫米）之间的关联进行直接和中介途径建模，这两个变量均作为连续潜在变量。使用结构方程模型对“牙龈炎”（可见菌斑；BoP）；“中度牙周炎”（PD ≥ 5 毫米和 CAL ≥ 5 毫米）和牙周炎（CDC-AAP 病例定义）的结果进行敏感性分析。
更高的“心血管疾病风险的系统性循环炎症负担”与更高的“初始牙周炎”直接相关（标准化系数 [SC] = 0.178，P 值 < 0.001）。较低的“社会经济地位”（SC = - 0.022，P 值 = 0.015）和吸烟（SC = 0.030，P 值 = 0.021）通过“心血管疾病风险的系统性循环炎症负担”引发了“初始牙周炎”。敏感性分析显示“心血管疾病风险的系统性循环炎症负担”与“中度牙周炎”之间存在剂量-反应关系（SC = 0.323，P 值 = 0.021）。
“心血管疾病风险的系统性循环炎症负担”似乎是青少年早期牙周破坏的潜在机制，也由社会脆弱性和吸烟引发。
成年期牙周炎与 CVD 之间的关联似乎比之前研究的更早建立，这为关注其共同危险因素的预防方法提供了动力。
