北京石景山社区中老年人群慢性牙周炎和颈动脉内膜中层厚度的相关性

Association between chronic periodontitis and carotid intima-media thickness of middle-aged and older adults in Shijingshan community of Beijing

目的:研究北京石景山社区中老年人群慢性牙周炎和颈动脉内膜中层厚度的相关性。方法:2005—2010年对北京石景山社区中老年人群进行了问卷调查、牙周临床指标检查、血生化检查及颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)的测量,共有830人纳入研究。根据2007年美国疾病控制和预防中心与美国牙周病学会制定的定义将牙周炎分为轻度和中重度组,测量了3个部位的CIMT:颈总动脉(common carotid artery intimamedia thickness,CCA-IMT)、颈内动脉(internal carotid artery intima-media thickness,ICA-IMT)和颈动脉分叉(carotid burfication intima-media thickness,CB-IMT),对混杂因素,如年龄、性别、受教育程度、高血压、高血脂、肥胖、吸烟、饮酒、糖尿病等进行校正后,用多因素回归分析方法研究牙周炎和不同部位CIMT的相关性。采用另一种牙周炎分类方法(AL≥3 mm的位点百分比<10%为轻度牙周炎,AL≥3 mm位点百分比在10%~30%为中度牙周炎,AL≥3 mm位点百分比≥30%为重度牙周炎),研究不同牙周炎分类方法是否会对结果产生影响。结果:中重度牙周炎组CCA-IMT、ICA-IMT、CB-IMT及平均CIMT都比轻度牙周炎组增厚,差异具有统计学意义;多因素回归分析显示中重度牙周炎比轻度牙周炎ICA-IMT增厚的风险增加1.230倍(95%CI:1.058~1.452,P=0.031)。采用第二种牙周炎分类方法进行回归分析发现,中度牙周炎比轻度牙周炎CB-IMT增厚风险增加1.297倍(95%CI:1.117~1.753,P=0.011),重度牙周炎比轻度牙周炎CB-IMT增厚风险增加1.771倍(95%CI:1.176~3.503,P=0.042)。结论:在该人群中,牙周炎和CIMT存在一定相关性,不同牙周炎分类方法会对结果产生影响。

Objective:To investigate the relationship between periodontal disease and subclinical atherosclerosis in middle-aged and older adults in Shijingshan community of Beijing.Methods:In 2005-2010,a total of 830 middle-aged and older adults were recruited from Shijingshan community of Beijing,who were divided into two groups by severity of periodontitis.A questionnaire,periodontal examination,blood biochemical examination,carotid intima-media thickness(CIMT),including common carotid artery(CCA-IMT),internal carotid artery(ICA-IMT)and carotid bifurcation(CB-IMT),were measured of each subject.The associations of periodontitis with CIMT was evaluated by multivariable Logistic regression analysis and analysis of covariance,adjusted for age,gender,education level,hypertension,hyperlipidemia,obesity,smoking,drinking,and diabetes.And then anther definition of periodontitis(mild periodontitis:percentage of AL≥3 mm<10%;moderate periodontitis:percentage of AL≥3 mm 10%-30%;severe periodontitis:percentage of AL≥3 mm≥30%)was used to investigate the hypotheses that different classification of periodontitis would affect results.Results:The subjects with moderate-severe periodontitis were characterized by significantly higher levels of CCA-IMT,ICA-IMT,CB-IMT and mean CIMT than the mild group.In the univariate analysis,moderate-severe periodontitis was associated with an increased risk of ICA-IMT>0.9 mm(adjusted OR=1.230,95%CI:1.058-1.452,P=0.031).Furthermore,moderate periodontitis was associated with an increased risk of CB-IMT>0.9 mm(adjusted OR:1.297,95%CI:1.117-1.753,P=0.011)and severe periodontitis was associated with an in-creased risk of CB-IMT>0.9 mm(adjusted OR=1.771,95%CI:1.176-3.503,P=0.042)according to another classification of periodontitis.Conclusion:Our data provided evidence that periodontitis was associated with CIMT among middle-aged and older adults in Shijingshan community of Beijing and different periodontitis classification would affect the results.