Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Periodontology, Department of Dentistry, Faculty of Health, Witten/Herdecke University, Germany.
Evid Based Dent. 2021 Dec;22(4):123-125. doi: 10.1038/s41432-021-0214-y. Epub 2021 Dec 16.
Data sources The electronic databases Medline, the Cochrane Central Register of Controlled Trials, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform, from inception to September 2020, were searched to identify the eligible studies measuring the association between periodontal disease and Alzheimer's disease or mild cognitive impairment.Study selection Cohort, cross-sectional and case-control studies, without any language restrictions, were selected by two reviewers independently.Data extraction and synthesis Data extraction and quality assessment were performed by two reviewers independently. Data was synthesised quantitatively with meta-analyses using a random or fixed-effects model, with P <0.1 considered statistically significant. Quality assessment of cohort and case-control studies was carried out using the Newcastle-Ottawa scale (NOS) and quality assessment of cross-sectional studies was undertaken using the Agency for Healthcare Research and Quality (AHRQ) tool. Heterogeneity of included studies was assessed with I2.Results Thirteen studies, including five cross-sectional studies, five case-control studies, two retrospective cohort studies and one prospective cohort study were found to be eligible. Meta-analyses showed elevated risk for Alzheimer's disease (odds ratio = 1.78; random-effects model; significant heterogeneity) and mild cognitive impairment (odds ratio = 1.60; fixed-effects model; low heterogeneity) in patients with periodontal disease. One case-control study and all cohort studies had high quality, while four case-control studies had medium quality, as evaluated by the NOS. Among the cross-sectional studies evaluated by the AHRQ tool, only one had high quality, whereas other studies had medium quality.Conclusions Within the limitations of the included studies, the authors concluded that periodontal disease is related to an elevated risk of Alzheimer's disease and mild cognitive impairment.
资料来源 从建库至 2020 年 9 月，检索了电子数据库 Medline、Cochrane 中央对照试验注册库、Embase、中国知网、中国科技期刊数据库、万方数据、ClinicalTrials.gov 和世界卫生组织国际临床试验注册平台，以识别评估牙周病与阿尔茨海默病或轻度认知障碍之间相关性的合格研究。
研究选择 由两位评审员独立选择无任何语言限制的队列研究、横断面研究和病例对照研究。
数据提取和综合 由两位评审员独立进行数据提取和质量评估。使用随机或固定效应模型进行定量数据合成，以 P＜0.1 为有统计学意义。使用纽卡斯尔-渥太华量表（NOS）评估队列和病例对照研究的质量，使用美国医疗保健研究与质量局（AHRQ）工具评估横断面研究的质量。使用 I2 评估纳入研究的异质性。
结果 共发现 13 项研究符合条件，包括 5 项横断面研究、5 项病例对照研究、2 项回顾性队列研究和 1 项前瞻性队列研究。荟萃分析显示，牙周病患者发生阿尔茨海默病（比值比=1.78；随机效应模型；显著异质性）和轻度认知障碍（比值比=1.60；固定效应模型；低异质性）的风险增加。1 项病例对照研究和所有队列研究的质量较高，而 NOS 评估的 4 项病例对照研究质量中等。在 AHRQ 工具评估的横断面研究中，仅有 1 项研究质量较高，而其他研究质量中等。
结论 在纳入研究的局限性内，作者得出结论，牙周病与阿尔茨海默病和轻度认知障碍的风险增加有关。
