The sex paradox in the interplay between periodontitis, obesity, and serum C-reactive protein: Data from a general population
The sex paradox in the interplay between periodontitis, obesity, and serum C-reactive protein: Data from a general population
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DOI：
10.1002/jper.18-0733
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发表时间：
2019-08-09
影响因子：
4.3
通讯作者：
Kocher, Thomas
中科院分区：
文献类型：
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作者：
Meisel, Peter;Eremenko, Michael;Kocher, Thomas
女性通常比男性牙周健康，但她们表现出更高的全身炎症标志物水平。我们的目的是评估这种悖论是否可以用肥胖或体型的不同分支来解释。方法在来自波美拉尼亚健康研究的3268名受试者中，我们测定了人体测量和牙周参数、c反应蛋白（CRP）和纤维蛋白原作为炎症标志物。行为和环境风险因素以及手握力被评估为影响结果的因素。我们评估了性别特异性的肥胖特征和牙周变量的关联，如探测深度（PD）与CRP和纤维蛋白原。结果在调整年龄、腰臀比、糖化血红蛋白、吸烟、教育程度、握力等因素后，证实了牙周炎和肥胖对CRP水平的异性影响。男性和女性WHR和体重指数（BMI）与CRP相关（P < 0.001）。CRP与男性PD相关（P = 0.001），而与女性PD无关（P = 0.11）。经BMI调整后，这种相关性在男性中减弱了15% (P = 0.002)，而在女性中减弱了70% （P = 0.58）。PD与两性探针上的斑块和出血有关（P < 0.001），也与女性（P = 0.026）和男性（P = 0.002）的WHR有关。BMI在女性中减弱了这种关联，但在男性中没有。HbA1c对女性PD有显著影响（P = 0.013），而对男性无显著影响（P = 0.76）。结论男性牙周炎和肥胖对全身CRP浓度有影响。在女性中，肥胖比男性更重要，超过了牙周测量的影响。
Background Women are generally periodontally healthier than men but they exhibit higher systemic levels of inflammatory markers. Our aim is to evaluate whether this paradox may be explained by different ramifications of adiposity or body shape. Methods In 3,268 subjects from the Study of Health in Pomerania, we determined anthropometric and periodontal parameters, C-reactive protein (CRP), and fibrinogen as markers of inflammation. Behavioural and environmental risk factors and hand grip strength were assessed as factors interfering with the outcomes in question. We evaluated sex-specific associations of adiposity characteristics and periodontal variables such as probing depth (PD) with CRP and fibrinogen. Results After adjusting for age, waist-to-hip ratio (WHR), glycated hemoglobin, smoking, education, and grip strength, the opposite sex role of periodontitis and obesity on CRP levels were confirmed. WHR and body mass index (BMI) were associated with CRP in both men and women (P < 0.001). CRP was associated with PD in men (P = 0.001) but not in women (P = 0.11). When adjusted for BMI this association was attenuated in men by 15% (P = 0.002) but in women by 70% (P = 0.58). PD was related to plaque and bleeding on probing (P < 0.001) in both sexes and also to WHR in women (P = 0.026) and men (P = 0.002). BMI attenuated this association in women but not in men. HbA1c contributed significantly to PD in women (P = 0.013) but not in men (P = 0.76). Conclusions Systemic CRP concentrations are affected by periodontitis and obesity in men. In women adiposity is more significant than in men overriding the impact of periodontal measures.