背景:虽然研究表明牙周病与心血管疾病风险增加之间存在关联,这种关联的强度及其与各种类型心血管疾病的具体联系尚未得到彻底研究.这项研究旨在研究牙龈炎和牙齿脱落如何影响心血管疾病,探索他们的个人影响。
方法:进行了一项回顾性队列研究,包括3,779,490名没有心血管疾病史的个体,利用2006年至2019年国家健康检查和韩国国家健康保险数据库的数据。Cox比例风险模型用于估计牙齿脱落之间的关联,牙龈炎,和心血管疾病。
结果:经过10.38年的中位随访,发现了17942例新的心血管疾病病例,包括10224例心绞痛,急性心肌梗死6182例,和9,536例中风。据观察,与对照组相比,牙齿脱落组的中风风险明显更高(调整后的风险比[aHR]:1.09,95%置信区间[CI]:1.04-1.15)。在牙龈炎和牙齿脱落的组中,卒中和心血管疾病的风险显著高于对照组(aHR:1.12,95%CI:1.04-1.20;aHR:1.08,95%CI:1.03-1.14).在50岁及以上的个体中,牙龈炎组显示出较高的与中风相关的风险(aHR:1.05,95%CI:1.01-1.10)。然而,没有观察到牙周病和心绞痛之间有统计学意义的关联,除50岁以上的人群外,牙周疾病和急性心肌梗死之间也不存在。此外,牙周病和心血管疾病之间的关联被发现在50岁以上的个体中,男性,那些肥胖的人,和吸烟者与对照组相比。
结论:我们的研究结果强调牙齿脱落和牙龈炎与心血管疾病的关系,特别是中风,强调预防性口腔保健的迫切需要。量身定制的干预措施对于降低心血管疾病事件的高风险是必要的。尤其是中风,在老年人中,肥胖者和吸烟者。
BACKGROUND: While studies have suggested an association between periodontal disease and an increased risk of cardiovascular disease, the strength of this association and its specific links to various types of cardiovascular disease have not been thoroughly investigated. This
study aimed to examine how gingivitis and tooth loss affect cardiovascular diseases, probing their individual impacts.
METHODS: A retrospective cohort
study was conducted, encompassing 3,779,490 individuals with no history of cardiovascular disease, utilizing data from the National Health Examination and the Korean National Health Insurance database from 2006 to 2019. Cox proportional hazards models were applied to estimate the association between tooth loss, gingivitis, and cardiovascular disease.
RESULTS: Following a median follow-up of 10.38 years, 17,942 new cardiovascular disease cases were identified, comprising 10,224 cases of angina pectoris, 6,182 cases of acute myocardial infarction, and 9,536 cases of stroke. It was observed that the risk of stroke was significantly higher in the tooth loss group compared to the control group (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.04-1.15). In the group with gingivitis and tooth loss, the risk of stroke and cardiovascular disease was significantly higher than in the control group (aHR: 1.12, 95% CI: 1.04-1.20; aHR: 1.08, 95% CI: 1.03-1.14). The gingivitis group exhibited a higher risk associated with stroke (aHR: 1.05, 95% CI: 1.01-1.10) among individuals aged 50 and above. However, statistically significant associations between periodontal disease and angina pectoris were not observed, nor between periodontal disease and acute myocardial infarction except among those aged above 50. Furthermore, the association between periodontal disease and cardiovascular disease was found to be stronger among individuals over the age of 50, males, those with obesity, and smokers compared to the control group.
CONCLUSIONS: Our results emphasize the association of tooth loss and gingivitis with cardiovascular disease, specifically stroke, underlining the critical need for preventive oral healthcare. Tailored interventions are necessary to reduce the heightened risk of cardiovascular disease events, especially stroke, among older, obese individuals and smokers.