Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Periodontal Res. 2022 Aug;57(4):824-834. doi: 10.1111/jre.13021. Epub 2022 Jun 8.
Previous epidemiological studies regarding the association between chronic periodontitis (CP) and carotid intima-media thickness (cIMT) and subclinical atherosclerosis have been inconclusive.
The aim of this study was to determine whether CP is associated with subclinical atherosclerosis in a large population-based cohort study conducted in northern Germany (the Hamburg City Health study).
Baseline data from 5781 participants of the Hamburg City Health Study with complete oral health and carotid ultrasound data (50.7% female, mean age: 62.1 ± 8.4 years) were evaluated. A standardized duplex sonography of the carotid artery was performed with measurement of carotid intima-media thickness (cIMT) and atherosclerotic plaques. Oral health was assessed by recording the decayed, missing, and filled teeth (DMFT) index, clinical attachment loss (CAL), bleeding on probing (BOP), and the dental plaque index (PI). Correlations were tested for statistical significance by means of descriptive statistics and multivariate regression analyses.
Moderate and severe CP were associated with the prevalence of cIMT ≥ 1 mm (none or mild CP: 5.1%, moderate CP: 6.1%, severe CP: 10%) and mean cIMT (none or mild CP: 0.72 mm, moderate CP: 0.75 mm, severe CP: 0.78 mm) in bivariate analyses (p < .001). Additionally, severe and moderate CP were associated with higher prevalence of carotid atherosclerotic plaques (plaque = yes: none or mild CP: 23.9%, moderate CP: 29%, severe CP: 40.2%,). After adjustment for age, sex, smoking, diabetes, hypertension, educational level, hypercholesterolemia, and hsCRP, severe CP still correlated significantly with cIMT and the prevalence of cIMT ≥1 mm and/or presence of carotid atherosclerotic plaques.
In this study, severe CP was associated with increased cIMT and higher prevalence of carotid plaques independent of common risk factors.
先前关于慢性牙周炎（CP）与颈动脉内膜中层厚度（cIMT）和亚临床动脉粥样硬化之间关联的流行病学研究结果并不一致。
本研究旨在通过在德国北部进行的一项大型基于人群的队列研究（汉堡城市健康研究），确定 CP 是否与亚临床动脉粥样硬化有关。
评估了汉堡城市健康研究中 5781 名具有完整口腔健康和颈动脉超声数据的参与者（50.7%为女性，平均年龄：62.1±8.4 岁）的基线数据。使用颈动脉双功能超声测量颈动脉内膜中层厚度（cIMT）和粥样斑块进行标准化的颈动脉超声检查。通过记录龋齿、缺失和补牙（DMFT）指数、临床附着丧失（CAL）、探诊出血（BOP）和牙菌斑指数（PI）来评估口腔健康。通过描述性统计和多变量回归分析来检验相关性的统计学意义。
在双变量分析中，中度和重度 CP 与 cIMT≥1mm 的患病率（无或轻度 CP：5.1%，中度 CP：6.1%，重度 CP：10%）和平均 cIMT（无或轻度 CP：0.72mm，中度 CP：0.75mm，重度 CP：0.78mm）相关（p<0.001）。此外，重度和中度 CP 与颈动脉粥样硬化斑块的患病率较高相关（斑块阳性：无或轻度 CP：23.9%，中度 CP：29%，重度 CP：40.2%）。在校正年龄、性别、吸烟、糖尿病、高血压、教育程度、高胆固醇血症和 hsCRP 后，重度 CP 仍与 cIMT 以及 cIMT≥1mm 和/或存在颈动脉粥样硬化斑块的患病率显著相关。
在这项研究中，重度 CP 与 cIMT 增加和颈动脉斑块患病率增加相关，独立于常见的危险因素。
