Periodontal disease and risk of cerebrovascular disease -: The First National Health and Nutrition Examination Survey and its follow-up study
Periodontal disease and risk of cerebrovascular disease -: The First National Health and Nutrition Examination Survey and its follow-up study
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DOI：
10.1001/archinte.160.18.2749
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发表时间：
2000-10-09
影响因子：
--
通讯作者：
Sempos, CT
中科院分区：
文献类型：
--
作者：
Wu, TJ;Trevisan, M;Sempos, CT
背景：牙周病已被发现是冠心病的一个潜在危险因素。然而，它与脑血管意外(CVA)的相关性研究要少得多。方法：本研究考察牙周病和CVA之间的关系。这项研究队列包括9962名年龄在25岁到74岁之间的成年人，他们参加了第一次全国健康和营养检查调查及其后续研究。基线牙周状态分为(1)无牙周病，(2)牙周炎，(3)牙周炎，(4)缺牙。所有CVA(国际疾病分类，第九次修订[ICD-9]，代码430-438)均由非致命事件的医院记录和致命事件的死亡证明确定。第一个CVA，非致命性或致命性，被用来定义发病率。通过COX比例风险模型中的风险比估计相对风险，并对几个人口统计学变量和公认的心血管风险因素进行调整。结果：牙周炎是CVA的重要危险因素，尤其是非出血性卒中(ICD-9,433-434和436-438)。与无牙周病相比，发生非出血性中风的相对危险度(95%可信区间)分别为：牙周炎1.24(0.74~2.08)、牙周炎2.11(1.30~3.42)、无牙1.41(0.96~2.06)。牙周炎为1.02(0.70~1.48)，牙周炎为1.66(1.15~2.39)，无牙合为1.23(0.91~1.66)。在白人男性、白人女性和非裔美国人中，总CVA和与牙周炎相关的非出血性中风的相对风险也增加。致死性CVA也有类似的结果。结论：牙周病是CVA的重要危险因素，尤其是非出血性卒中。
Background: Periodontal disease has been found to be a potential risk factor for coronary heart disease. However, its association with cerebrovascular accidents (CVAs) is much less studied.Methods: This study examines the association between periodontal disease and CVA. The study cohort comprises 9962 adults aged 25 to 74 years who participated in the First National Health and Nutrition Examination Survey and its follow-up study. Baseline periodontal status was categorized into (1) no periodontal disease, (2) gingivitis, (3) periodontitis, and (4) edentulousness. All CVAs (International Classification of Diseases, Ninth Revision [ICD-9], codes 430-438) were ascertained by hospital records for nonfatal events and death certificates for fatal events. The first CVA, nonfatal or fatal, was used to define incidence. Relative risks were estimated by hazard ratios from the Cox proportional hazard model with adjustment for several demographic variables and well-established cardiovascular risk factors. Weights were used to generate risk estimates.Results: Periodontitis is a significant risk factor for total CVA and, in particular, nonhemorrhagic stroke (ICD-9, 433-434 and 436-438). Compared with no periodontal disease, the relative risks (95% confidence intervals) for incident nonhemorrhagic stroke were 1.24 (0.74-2.08) for gingivitis, 2.11 (1.30-3.42) for periodontitis, and 1.41 (0.96-2.06) for edentulousness. For total CVA, the results were 1.02 (0.70-1.48) for gingivitis, 1.66 (1.15-2.39) for periodontitis, and 1.23 (0.91-1.66) for edentulousness. Increased relative risks for total CVA and nonhemorrhagic stroke associated with periodontitis were also seen in white men, white women, and African Americans. Similar results were found for fatal CVA.Conclusion: Periodontal disease is an important risk factor for total CVA and, in particular, nonhemorrhagic stroke.