Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan.
Department of Preventive Cardiology, National Cerebral and Cardiovascular Centre, Osaka, Japan.
J Clin Periodontol. 2023 Feb;50(2):265-275. doi: 10.1111/jcpe.13740. Epub 2022 Nov 20.
To investigate the association between periodontal disease and atherosclerosis and to examine whether the association is modified by hypertension status.
In this cross-sectional study, 1472 Japanese individuals aged 50-79 years who underwent a medical check-up, dental examination, and carotid ultrasonography were studied. Carotid atherosclerosis was expressed as the maximum and mean carotid intima-media thickness (max-IMT, mean-IMT) and the presence of stenosis (≥75%). Periodontal status was examined by the Community Periodontal Index (CPI, codes 0-4). The participants were divided into three groups according to the periodontal status (CPI0-2, CPI3, CPI4).
A positive correlation was found between mean-IMT and periodontal disease after adjustment for cardiovascular risk factors in the entire cohort (mean-IMT in hypertensives: CPI0-2: 0.848 mm, CPI3: 0.857 mm, CPI4: 0.877 mm; normotensives: 0.782, 0.802, 0.826). In the entire cohort, the multivariable-adjusted odds ratio of stenosis based on mean-IMT significantly increased according to periodontal status in normotensives (odds ratio; CPI0-2: 1, CPI3: 1.39, CPI4: 2.53; p-value for trend = .004) but showed only marginal significant increase in hypertensives (1, 1.15, 1.55; p-value for trend = .063). No significant relationships were observed for max-IMT in all analyses.
We observed an association between periodontal disease and atherosclerosis in normotensive and hypertensive participants.
探讨牙周病与动脉粥样硬化的关系,并研究这种关系是否受高血压状态的影响。
本横断面研究纳入了 1472 名年龄在 50-79 岁之间的日本个体,他们接受了体检、牙科检查和颈动脉超声检查。颈动脉粥样硬化用最大和平均颈动脉内膜中层厚度(max-IMT、mean-IMT)和狭窄程度(≥75%)来表示。牙周状况通过社区牙周指数(CPI,代码 0-4)进行评估。根据牙周状况(CPI0-2、CPI3、CPI4)将参与者分为三组。
在校正心血管危险因素后,整个队列中平均 IMT 与牙周病呈正相关(高血压患者:CPI0-2:0.848mm,CPI3:0.857mm,CPI4:0.877mm;血压正常者:0.782mm,0.802mm,0.826mm)。在整个队列中,根据平均 IMT,在血压正常者中,狭窄的多变量校正比值比随着牙周状况的增加而显著增加(比值比;CPI0-2:1,CPI3:1.39,CPI4:2.53;趋势检验 p 值=0.004),但在高血压患者中仅呈边际显著增加(1,1.15,1.55;趋势检验 p 值=0.063)。在所有分析中,max-IMT 与牙周病之间均无显著关系。
我们观察到在血压正常和高血压患者中,牙周病与动脉粥样硬化之间存在关联。