Division of Cardiovascular Medicine, Department of Internal Medicine, Providence VA Medical Center, Providence, Rhode Island; Division of Cardiovascular Medicine, Department of Internal Medicine, Alpert Medical School at Brown University, Providence, Rhode Island.
Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia.
Am J Cardiol. 2022 Sep 1;178:163-168. doi: 10.1016/j.amjcard.2022.05.028. Epub 2022 Jun 27.
As observational studies support the association between periodontal disease (PD) and cardiovascular diseases (CVDs), we examined this relationship using the National Health and Nutrition Examination Survey 2013 to 2014 data. This cross-sectional study involved 2,830 adult participants, aged ≥30 years who underwent a home interview, followed by a standardized assessment at a mobile examination center from 2013 to 2014. PD was defined using the new classification scheme issued by American Academy of Periodontology Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions in 2017, and CVD was defined as the composite of coronary artery disease and stroke. The gathered data were subjected to weighted statistical analysis to examine the relation between CVD prevalence and PD. The sample (mean age 51.5 ± 13.6 years) comprised 50.1% men and 69.5% White participants. Stage I (mild/subclinical), II (moderate), and III to IV (severe) PD was noted in 16.7% (95% confidence interval [CI] 12.7 to 21.7), 57.4% (95% CI 53.9 to 60.9), and 25.9% (95% CI 21.4 to 30.8) of the participants, respectively. Patients with stage III and IV PD were more likely to have CVD than those with stage I (adjusted odds ratio 3.59, 95% CI 1.12 to 11.54, p = 0.03). Similarly, participants who reported fair/poor gum health were more likely to have CVD than those who reported excellent/very good gum health (adjusted odds ratio 2.17, 95% CI 0.98 to 4.79, p = 0.055). In conclusion, the data from the National Health and Nutrition Examination Survey 2013 to 2014 demonstrated that PD severity is associated with CVD risk. However, the information gathered by trained professionals during periodontal examinations is a more reliable predictor of PD-CVD associations compared with self-reported measures of oral health.
由于观察性研究支持牙周病（PD）与心血管疾病（CVDs）之间的关联，我们使用 2013 年至 2014 年的国家健康和营养调查（NHANES）数据来检验这种关系。这项横断面研究涉及 2830 名年龄≥30 岁的成年参与者，他们在 2013 年至 2014 年期间接受了家庭访谈，随后在移动体检中心进行了标准化评估。PD 使用 2017 年美国牙周病学会工作组发布的牙周病和种植体周围疾病及状况新分类方案定义，CVD 定义为冠心病和中风的综合。收集的数据经过加权统计分析，以检验 CVD 患病率与 PD 之间的关系。该样本（平均年龄 51.5±13.6 岁）由 50.1%的男性和 69.5%的白人参与者组成。I 期（轻度/亚临床）、II 期（中度）和 III 期至 IV 期（重度）PD 的发生率分别为 16.7%（95%可信区间 [CI] 12.7 至 21.7）、57.4%（95% CI 53.9 至 60.9）和 25.9%（95% CI 21.4 至 30.8）。与 I 期 PD 患者相比，III 期和 IV 期 PD 患者更有可能患有 CVD（调整后的优势比 3.59，95%可信区间 1.12 至 11.54，p=0.03）。同样，报告牙龈健康状况一般/差的参与者比报告牙龈健康状况极好/非常好的参与者更有可能患有 CVD（调整后的优势比 2.17，95%可信区间 0.98 至 4.79，p=0.055）。总之，2013 年至 2014 年国家健康和营养调查的数据表明，PD 的严重程度与 CVD 风险相关。然而，与自我报告的口腔健康测量相比，牙周检查中由经过培训的专业人员收集的信息是 PD-CVD 关联的更可靠预测指标。
