Poor oral health and coronary heart disease
Poor oral health and coronary heart disease
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DOI：
10.1177/00220345960750090301
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发表时间：
1996-09-01
影响因子：
7.6
通讯作者：
Willett, WC
中科院分区：
文献类型：
--
作者：
Joshipura, KJ;Rimm, EB;Willett, WC
最近的一些研究表明，口腔健康不良与冠心病（CHD）之间存在关联。本研究的目的是在一项前瞻性队列研究中检查CHD的发病率与牙齿数量和牙周病的关系，并探讨这种关联的潜在介质。这项研究是正在进行的卫生专业人员随访研究（HPFS）的一部分。参与者包括44，119名男性卫生专业人员（其中58%是牙医）的美国全国样本，年龄在40至75岁之间，他们在基线时没有被诊断为CHD，癌症或糖尿病。我们在6年的随访中记录了757例冠心病事件，包括致命性和非致命性心肌梗死和猝死。在报告先前存在牙周病的男性中，在校正标准CHD风险因素后，与25颗或更多牙齿的男性相比，10颗或更少牙齿的男性患CHD的风险增加（相对风险= 1.67; 95%置信区间，1.03至2.71）。在没有牙周病的男性中，没有发现相关性（相对危险度= 1.11; 95%置信区间，0.74至1.68）。在我们控制了饮食因素后，这种关联只略有减弱。牙周病和冠心病之间没有发现整体关联。牙齿脱落可能与冠心病风险增加有关，主要是在那些有积极的牙周病史的人中;饮食只是这种关联的一个小中介。
A few recent studies have shown associations between poor oral health and coronary heart disease (CHD). The objective of this study was to examine the incidence of CHD in relation to number of teeth present and periodontal disease, and to explore potential mediators of this association, in a prospective cohort study. This study is a part of the ongoing Health Professionals Follow-Up Study (HPFS). Participants included a US national sample of 44,119 male health professionals (58% of whom were dentists), from 40 to 75 years of age, who reported no diagnosed CHD, cancer, or diabetes at baseline. We recorded 757 incident cases of CHD, including fatal and non-fatal myocardial infarction and sudden death, in six years of follow-up. Among men who reported pre-existing periodontal disease, those with 10 or fewer teeth were at increased risk of CHD compared with men with 25 or more teeth (relative risk = 1.67; 95% confidence interval, 1.03 to 2.71), after adjustment for standard CHD risk factors. Among men without pre-existing periodontal disease, no relationship was found (relative risk = 1.11; 95% confidence interval, 0.74 to 1.68). The associations were only slightly attenuated after we controlled for dietary factors. No overall associations were found between periodontal disease and coronary heart disease. Tooth loss may be associated with increased risk of CHD, primarily among those with a positive periodontal disease history; diet was only a small mediator of this association.