Skipina Travis M, Elhawary Mona M, Soliman Elsayed Z
Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
Liverpool John Moores University, Liverpool, England.
Am J Med Sci. 2022 Sep;364(3):327-332. doi: 10.1016/j.amjms.2022.04.002. Epub 2022 Apr 9.
Periodontal disease (PD) has been linked to a range of cardiometabolic disorders. However, the association between PD and composite cardiovascular risk has not been studied. We hypothesized that PD would be associated with an elevated atherosclerotic cardiovascular risk (ASCVD) score.
This analysis included 12,402 participants (age 42.7 ± 18.6 years, 46.8% male, 69.6% Caucasian) from the Third National Health and Nutrition Examination Survey. Participants with a history of myocardial infarction or stroke were excluded. PD was defined as moderate (≥4mm attachment loss or ≥5 mm pocket depth in ≥2 mesial sites) or severe (≥6 mm attachment loss in ≥2 mesial sites and ≥5 mm pocket depth in ≥1 mesial site). ASCVD scores were classified categorically: low (<5.0%), borderline (5.0-7.4%), intermediate (7.5-19.9%), and high (≥20.0%). Linear and multinomial logistic regression were used to examine the association between PD and ASCVD score.
Approximately 12.1% (n = 1499) of participants had PD. Moderate periodontitis was associated with a greater than five-fold increased odds of high-risk ASCVD score [OR (95% CI): 5.40 (4.63-6.31), p-value <0.001]. Severe periodontitis was associated with a greater than seven-fold increased odds of high-risk ASCVD score [OR (95% CI): 7.15 (5.14-9.96), p-value <0.001]. Composite periodontitis (moderate or severe) was associated with a 7.0% increase in ASCVD score [β (95% CI): 7.01 (6.53-7.50)] when modeled linearly.
PD is associated with elevated ASCVD score. Patients with PD should be counseled regarding their elevated cardiovascular risk and risk reduction strategies should be implemented with an emphasis on routine dental care.
牙周疾病（PD）与一系列心脏代谢紊乱有关。然而，PD与综合心血管风险之间的关联尚未得到研究。我们假设PD会与升高的动脉粥样硬化心血管风险（ASCVD）评分相关。
该分析纳入了来自第三次全国健康与营养检查调查的12402名参与者（年龄42.7±18.6岁，46.8%为男性，69.6%为白种人）。排除有心肌梗死或中风病史的参与者。PD被定义为中度（≥4mm附着丧失或≥2个近中位点的袋深≥5mm）或重度（≥2个近中位点的附着丧失≥6mm且≥1个近中位点的袋深≥5mm）。ASCVD评分被分类为：低（<5.0%）、临界（5.0 - 7.4%）、中等（7.5 - 19.9%）和高（≥20.0%）。使用线性和多项逻辑回归来检验PD与ASCVD评分之间的关联。
约12.1%（n = 1499）的参与者患有PD。中度牙周炎与高危ASCVD评分的几率增加超过五倍相关[比值比（95%置信区间）：5.40（4.63 - 6.31），p值<0.001]。重度牙周炎与高危ASCVD评分的几率增加超过七倍相关[比值比（95%置信区间）：7.15（5.14 - 9.96），p值<0.001]。当进行线性建模时，综合牙周炎（中度或重度）与ASCVD评分增加7.0%相关[β（95%置信区间）：7.01（6.53 - 7.50）]。
PD与升高的ASCVD评分相关。应向PD患者咨询其升高的心血管风险，并应实施风险降低策略，重点是常规牙科护理。
