Periodontal disease is associated with renal insufficiency in the atherosclerosis risk in communities (ARIC) study
Periodontal disease is associated with renal insufficiency in the atherosclerosis risk in communities (ARIC) study
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DOI：
10.1053/j.ajkd.2004.12.009
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发表时间：
2005-04-01
影响因子：
13.2
通讯作者：
Falk, RJ
中科院分区：
文献类型：
--
作者：
Kshirsagar, AV;Moss, KL;Falk, RJ
背景：牙周炎是一种慢性口腔细菌感染，是动脉粥样硬化性心血管疾病（CVD）的新危险因素。鉴于CVD和慢性肾脏病（CKD）的许多共同风险因素，我们假设牙周炎也与社区牙科动脉粥样硬化风险研究中的肾功能不全有关。方法：我们对5,537名中年黑人和白色男性和女性进行了横断面研究。牙周炎通过使用独立的临床定义确定，并分类为健康/牙龈炎，初始和严重。肾功能不全定义为肾小球滤过率（GFR）低于60 mL/min/1.73 m 2。多变量逻辑回归模型用于估计比值比和95%置信区间的肾功能不全使用健康/牙龈炎作为参照组。结果：共有2，276人患有初始牙周炎，947人患有重度牙周病。110名个体（2%）的GFR低于60 mL/mln/1.73 m（2）。与健康/牙龈炎相比，初始和严重牙周病与GFR小于60 mL/min/1.73m2相关（比值比，2.00; 95%可信区间，1.23 - 3.24），严重牙周病的优势比为2.14（95%置信区间，1.19至3.85）校正CVD和CKD的重要风险因素后。敏感性分析显示，初始和严重牙周炎分别与血清肌酐水平升高（男性> 1.4 mg/dL [> 124 μ mol/L];女性> 1.2 mg/dL [> 106 μ mol/L];比值比3.21; 95%置信区间1.32 - 7.76，比值比5.39; 95%置信区间，分别为2.08至13.99）。结论：这是第一个研究表明牙周病与普遍的肾功能不全。有必要进行前瞻性研究，以确定所观察到的关系的确切性质。(c)2005年由国家肾脏基金会，公司，
Background: Periodontitis, a chronic bacterial infection of the oral cavity, is a novel risk factor for atherosclerotic cardiovascular disease (CVD). Given the numerous shared risk factors for CVD and chronic kidney disease (CKD), we hypothesized that periodontitis also is associated with renal insufficiency in the Dental Atherosclerosis Risk in Communities study. Methods: We conducted a cross-sectional study of 5,537 middle-aged black and white men and women. Periodontitis was determined by using an independent clinically derived definition and categorized as healthy/gingivitis, initial, and severe. Renal insufficiency is defined as glomerular filtration rate (GFR) less than 60 mL/min/1.73 m(2). Multivariable logistic regression models were used to estimate odds ratios and 95% confidence intervals for renal insufficiency using healthy/gingivitis as the referent group. Results: A total of 2,276 individuals had initial periodontitis, and 947 individuals had severe periodontal disease. One hundred ten individuals (2%) had a GFR less than 60 mL/mln/1.73 m(2). Compared with healthy/gingivitis, initial and severe periodontal disease were associated with a GFR less than 60 mL/min/1.73 m 2 (odds ratio, 2.00; 95% confidence interval, 1.23 to 3.24) for initial periodontal disease and an odds ratio of 2.14 for severe disease (95% confidence interval, 1.19 to 3.85) after adjustment for important risk factors for CVD and CKD. Sensitivity analysis showed that initial and severe periodontitis were each associated with an elevated serum creatinine level (men, > 1.4 mg/dL [> 124 mu mol/L]; women, > 1.2 mg/dL [> 106 mu mol/L]; odds ratio, 3.21; 95% confidence interval, 1.32 to 7.76 and odds ratio, 5.39; 95% confidence interval, 2.08 to 13.99, respectively). Conclusion: This is the first study to show an association of periodontal disease with prevalent renal insufficiency. A prospective study is necessary to determine the exact nature of the observed relationship. (c) 2005 by the National Kidney Foundation, Inc,