口腔健康与微血管和大血管并发症发生风险的关联：一项对24862名糖尿病患者的前瞻性队列研究。
Association of oral health with risk of incident micro and macrovascular complications: A prospective cohort study of 24,862 people with diabetes.
作者信息
Gibson Alice A, Cox Emma, Gale Joanne, Craig Maria E, King Shalinie, Chow Clara K, Colagiuri Stephen, Nassar Natasha
机构信息
Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
出版信息
Diabetes Res Clin Pract. 2023 Sep;203:110857. doi: 10.1016/j.diabres.2023.110857. Epub 2023 Aug 9.
AIMS
To investigate the association between self-reported oral health and incident micro and macrovascular diabetes complications.
METHODS
This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The participants were 24,862 men and women, aged ≥45 years, with diabetes at baseline (2006-2009). The oral health of participants was assessed by questionnaire. Incident diabetes complications were determined using hospitalisation data and claims for medical services up until 2019. Hazard ratios for the association between oral health and incident complications were calculated using multivariable cox proportional hazards models.
RESULTS
Almost 60 % of participants had <20 teeth, and 38 % rated their teeth and gums as fair or poor. Compared with those with ≥20 teeth, those with 0 teeth had an increased risk of cardiovascular disease (aHR 1.24, 95 % CI: 1.15, 1.35), lower limb (aHR 1.22, 95 % CI: 1.11, 1.33) and kidney (aHR 1.19, 95 % CI: 1.11, 1.29) complications. Individuals with 1-9 teeth had an increased risk of eye complications (aHR 1.14, 95 % CI: 1.07, 1.22). The associations were generally consistent for poor self-rated teeth and gums.
CONCLUSIONS
Self-reported oral health measures may be a marker of elevated risk of complications in people with diabetes.
目的
研究自我报告的口腔健康与新发微血管和大血管糖尿病并发症之间的关联。
方法
这项前瞻性队列研究将澳大利亚45岁及以上研究的数据与行政健康记录相链接。参与者为24862名年龄≥45岁的男性和女性，基线时（2006 - 2009年）患有糖尿病。通过问卷调查评估参与者的口腔健康。使用住院数据和截至2019年的医疗服务索赔来确定新发糖尿病并发症。使用多变量Cox比例风险模型计算口腔健康与新发并发症之间关联的风险比。
结果
近60%的参与者牙齿不足20颗，38%的人将他们的牙齿和牙龈评为一般或较差。与牙齿≥20颗的人相比，牙齿为0颗的人患心血管疾病（调整后风险比1.24，95%置信区间：1.15，1.35）、下肢（调整后风险比1.22，95%置信区间：1.11，1.33）和肾脏（调整后风险比1.19，95%置信区间：1.11，1.29）并发症的风险增加。牙齿为1 - 9颗的人患眼部并发症的风险增加（调整后风险比1.14，95%置信区间：1.07，1.22）。自我报告的牙齿和牙龈状况较差时，这些关联通常是一致的。
结论
自我报告的口腔健康指标可能是糖尿病患者并发症风险升高的一个标志。
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