School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
Beijing Laboratory of Oral Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
BMC Oral Health. 2021 Dec 7;21(1):621. doi: 10.1186/s12903-021-01951-z.
Convincing evidence of the periodontitis as a risk factor for coronary heart disease (CHD) is lacking due to shared risk factors, and no cohort study has investigated the association between CHD and periodontitis in Chinese populations.
This study used a prospective cohort study design. The analysis included 4591 participants aged 40 years and older (3146 men and 1445 women). The association between CHD and periodontitis was estimated using relative risk (RR) calculated using modified Poisson regression. Multiple mediation analysis was used to differentiate the relative effects (RE) from different risk factors on the effect of periodontitis on CHD.
In the analysis using the imputed dataset and fully adjusted model, participants with periodontitis at baseline had 37% increased risk of CHD overall compared to those without periodontitis at baseline (RR 1.37; 95% CI 0.96-1.95). Most of the association can be explained by age, sex, history of diabetes, history of hypertension, uric acid and education (RE 0.76; 95% CI 0.41-1.02).
Periodontitis was weakly associated with an increased risk of CHD among the middled-aged and elderly in China. Further studies are required to identify more mediators and elucidate the mechanisms of how periodontitis increases the risk of CHD.
由于存在共同的危险因素,牙周炎作为冠心病(CHD)危险因素的证据尚不充分,而且还没有队列研究调查过中国人群中 CHD 与牙周炎之间的关联。
本研究采用前瞻性队列研究设计。共纳入了 4591 名年龄在 40 岁及以上的参与者(3146 名男性和 1445 名女性)。使用校正泊松回归计算的相对风险(RR)来估计 CHD 与牙周炎之间的关联。采用多重中介分析来区分不同危险因素对牙周炎与 CHD 之间关系的相对效应(RE)。
在使用插补数据集和完全调整模型的分析中,与基线时无牙周炎的参与者相比,基线时患有牙周炎的参与者发生 CHD 的总体风险增加了 37%(RR 1.37;95% CI 0.96-1.95)。该关联的大部分可以通过年龄、性别、糖尿病史、高血压史、尿酸和教育程度来解释(RE 0.76;95% CI 0.41-1.02)。
在中国的中老年人群中,牙周炎与 CHD 风险增加呈弱相关。需要进一步研究以确定更多的中介因素,并阐明牙周炎如何增加 CHD 风险的机制。