目的:本研究调查了甘油三酯-葡萄糖(TyG)指数与胰岛素抵抗的替代标志,和中度/重度牙周炎以及血压在这种关联中的中介作用。第二个目的是评估肥胖等心脏代谢疾病的作用,高血压,和血脂异常作为潜在的效应调节剂。
方法:分析了5733名年龄在30-64岁的美国成年人的完整牙周检查数据(NHANES2011-2014)。根据CDC/AAP标准将参与者分为中度/重度牙周炎或轻度/无牙周炎作为结果。曝光是TyG指数,而两者都是收缩压(SBP),使用参数g公式测试舒张压(DBP)血压作为介质。对相关混杂因素进行了分析调整,即,年龄,性别,种族,贫困收入比,吸烟,使用逆概率处理加权。肥胖状态(基于体重指数≥30kg/m2),对高血压和血脂异常的自我报告(根据国家胆固醇教育计划-成人治疗小组-III提供的阈值计算)作为效应修正因子进行了测试.
结果:研究结果表明,TyG指数与中度/重度牙周炎的几率增加有关[优势比(OR),95%置信区间(CI)=1.17(1.11-1.23)],总效应的50%由SBP介导。分层分析显示,肥胖个体的相关性更强,高血压,与没有这些条件的人相比,血脂异常。然而,那些服用抗高血压药物的人,该关联部分缓解.使用估算数据的敏感性分析显示出一致的结果。
结论:TyG指数与中度/重度牙周炎的几率增加有关,尤其是在肥胖的个体中,高血压,和血脂异常。SBP水平部分介导了这种关联。
OBJECTIVE: This study investigated the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and moderate/severe periodontitis and the role of blood pressure as a mediator in this association. A second aim was to assess the role of cardiometabolic conditions such as obesity, hypertension, and dyslipidemia as potential effect modifiers.
METHODS: Data from 5733 US adults aged 30-64 years and with complete periodontal examination were analyzed (NHANES 2011-2014). Participants were classified as having moderate/severe periodontitis or mild/no periodontitis according to the CDC/AAP criteria as the outcome. The exposure was the TyG index, while both systolic (SBP), and diastolic (DBP) blood pressure were tested as mediators using parametric g-formula. Analyses were adjusted for relevant confounders, namely, age, sex, ethnicity, poverty-income ratio, and smoking, using inverse probability treatment weighting. Obesity status (based on a body mass index ≥30 kg/m2), self-report of hypertension and dyslipidemia (calculated based on the thresholds provided by National Cholesterol Education Program-Adult Treatment Panel-III) were tested as effect modifiers.
RESULTS: The findings showed the TyG index to be associated with increased odds of moderate/severe periodontitis [odds ratio (OR), 95% confidence interval (CI) = 1.17 (1.11-1.23)], with 50% of the total effect mediated by SBP. Stratified analysis showed a stronger association in individuals with obesity, hypertension, and dyslipidemia compared to those without these conditions. However, in those taking anti-hypertensive medications, the association was partially mitigated. Sensitivity analysis using imputed data showed consistent results.
CONCLUSIONS: The TyG index was associated with increased odds of moderate/severe periodontitis, especially in individuals with obesity, hypertension, and dyslipidemia. SBP levels partially mediated this association.