Walther Carolin, Lieske Berit, Borof Katrin, Kühn Simone, Härter Martin, Löwe Bernd, Beikler Thomas, Heydecke Guido, Kuta Piotr, Seedorf Udo, Spinler Kristin, Gallinat Jürgen, Aarabi Ghazal
Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Brain Behav Immun Health. 2023 Sep 25;34:100689. doi: 10.1016/j.bbih.2023.100689. eCollection 2023 Dec.
The aim of the current study is to investigate the association between periodontitis (exposure variable) and depression severity (outcome variable) in an older German population. We evaluated data from 6,209 participants (median age 62 years) of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Depression severity were assessed with the 9-item Patient Health Questionnaire (PHQ-9). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Multiple linear regression models were adjusted for age, sex, diabetes, education, smoking, and antidepressant medication. Linear regression analyses revealed a significant association between log-transformed depression severity and periodontitis when including the interaction term for periodontitis * age, even after adjusting for age, sex, diabetes, education, smoking and antidepressant medication. We identified a significant association between severe periodontitis and elevated depression severity, which interacts with age. Additionally, we performed a linear regression model for biomarker analyses, which revealed significant associations between depression severity and severe periodontitis with log-transformed inflammatory biomarkers interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP). In order to identify new therapeutic strategies for patients with depression and periodontal disease, future prospective studies are needed to assess the physiological and psychosocial mechanisms behind this relationship and the causal directionality.
本研究的目的是调查德国老年人群中牙周炎（暴露变量）与抑郁严重程度（结果变量）之间的关联。我们评估了汉堡城市健康研究（HCHS）中6209名参与者（中位年龄62岁）的数据。HCHS是一项前瞻性队列研究，已在ClinicalTrial.gov注册（NCT03934957）。使用9项患者健康问卷（PHQ-9）评估抑郁严重程度。牙周检查包括探诊深度、牙龈退缩、菌斑指数和探诊出血。描述性分析按牙周炎严重程度分层。多元线性回归模型对年龄、性别、糖尿病、教育程度、吸烟和抗抑郁药物进行了调整。线性回归分析显示，即使在对年龄、性别、糖尿病、教育程度、吸烟和抗抑郁药物进行调整后，当纳入牙周炎*年龄的交互项时，对数转换后的抑郁严重程度与牙周炎之间仍存在显著关联。我们发现重度牙周炎与抑郁严重程度升高之间存在显著关联，且这种关联与年龄相互作用。此外，我们进行了生物标志物分析的线性回归模型，结果显示抑郁严重程度与重度牙周炎与对数转换后的炎症生物标志物白细胞介素6（IL-6）和高敏C反应蛋白（hsCRP）之间存在显著关联。为了确定抑郁症和牙周病患者的新治疗策略，需要未来的前瞻性研究来评估这种关系背后的生理和心理社会机制以及因果方向性。
