Jacobi Nicole, Walther Carolin, Borof Katrin, Heydecke Guido, Seedorf Udo, Lamprecht Ragna, Beikler Thomas, Debus Sebastian E, Waldeyer Christoph, Blankenberg Stefan, Schnabel Renate B, Aarabi Ghazal, Behrendt Christian-Alexander
Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
J Clin Med. 2021 May 11;10(10):2048. doi: 10.3390/jcm10102048.
Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study.
This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957).
MATERIAL & METHODS: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension.
The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006-1.591; = 0.045) was independently associated with PAOD.
In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.
外周动脉闭塞性疾病（PAOD）和牙周炎是常见的慢性疾病，全球共有近10亿人受其影响。越来越多的证据表明，牙周炎等慢性炎症性疾病与PAOD之间存在关联。本研究旨在利用高质量的研究数据以及源自一项流行病学队列研究的多种表型，确定这两种疾病之间的关联。
这项基于人群的横断面队列研究纳入了汉堡城市健康研究（NCT03934957）中3271名年龄在45至74岁之间参与者的数据。
采用踝臂指数低于0.9、下肢动脉彩色编码超声检查以及调查数据来确定无症状或有症状PAOD的参与者。牙周炎数据在每颗牙齿的六个部位收集，包括探诊深度、牙龈退缩、临床附着丧失以及探诊出血指数。使用逻辑回归模型进行多变量分析，并对年龄、性别、吸烟、教育程度、糖尿病和高血压等变量进行了调整。
未患牙周炎和PAOD的参与者与同时患有PAOD和重度牙周炎的组之间，基线特征差异很大。在两种疾病都患有的组中，男性比例更高、年龄更大、教育水平更低、吸烟、患糖尿病和心血管疾病的比例更高。调整后，重度牙周炎的存在（比值比1.265；97.5%可信区间1.006 - 1.591；P = 0.045）与PAOD独立相关。
在这项前瞻性队列研究的横断面分析中，揭示了牙周炎与PAOD之间的独立关联。本研究结果强调了在一个极其敏感的目标人群中预防医学的潜力。未来的研究应确定影响这两种疾病之间关系的潜在因素。
