PERIODONTITIS AND SYSTEMIC DISEASE-- CONFOUNDING?

牙周炎与系统性疾病有关，如 心血管疾病和低出生体重。确定…的因果关系 这些联系是困难的；比较的群体、具有和 没有牙周炎，可能会在牙周炎以外的其他因素上有所不同。如果这些 其他因素与系统性疾病风险有因果关系，可能存在混淆 现在时。本R03提案的主要目标是提供一种方法 运用不同方法研究混杂现象。这项方法论工作 将在三个大型数据库中执行：第一个国民健康和 营养检查调查(NHANES I)(n=31,973) 流行病学跟踪研究(NHEFS)(n=11,348)，第三次国家 健康与营养检查调查(NHANES III)(n=30,818)。详尽无遗 有关大多数潜在混杂变量的信息请参见 这些数据集(每个人超过1000个变量)。初步 对NHANES I和NHEFS的分析表明，混淆是一个重要的 方法上的挑战。牙周炎与意外有关 这些差异本身可能会导致其他系统性疾病。 经过年龄和性别调整后，牙周炎患者的 可能有不健康的饮食(水果少，维生素C少，核黄素少， 和较少的亚油酸)，更有可能遭受神经崩溃， 不太可能锻炼，更有可能超重，更有可能 高血压。此外，在对已知风险因素进行调整后， 牙周炎与肺癌死亡率增加两倍有关， 一项意想不到的发现表明，混淆可能会对 影响力。本研究的目的是：1)提供一个系统的评估 NHANES I和NHANES III中的潜在混杂变量；2)提供 牙周炎与MOST相关性的系统评价 NHEFS死亡的常见原因，3)评估使用 NHEFS队列研究中的替代参照组或未暴露组；以及4)至 执行一系列敏感性分析以评估以下情况的程度 混杂的变量可能会导致虚假的关联。调查人员 我相信这些项目的完成可能在决定 之前观察到的牙周炎和系统性牙周炎之间的联系 疾病是虚假的或有因果关系的。

Periodontitis has been associated with systemic diseases such as cardiovascular disease and low birth weight. Establishing the causality of these associations is difficult; the compared groups, individuals with and without periodontitis, may differ on factors other than periodontitis. If these other factors are causally related to systemic disease risk, confounding may be present. The primary goal of this R03 proposal is to provide a methodological study of confounding by means of different approaches. This methodological work will be performed in three large databases: the First National Health & Nutrition Examination Survey (NHANES I) (n=31,973), the NHANES I Epidemiological Follow-up Study (NHEFS) (n=11,348), and the Third National Health & Nutrition Examination Survey (NHANES III) (n=30,818). Exhaustive information regarding most potentially confounding variables is present in these datasets (greater than 1000 variables per individual). Preliminary analyses of the NHANES I and NHEFS suggest that confounding is a significant methodological challenge. Periodontitis was associated with unexpected differences that may in and of itself cause other systemic diseases. Individuals with periodontitis, after adjustment for age and gender, were more likely to have an unhealthy diet (less fruit, less vitamin C, less riboflavin, and less linoleic acid), were more likely to have suffered a nervous breakdown, less likely to exercise, more likely to be overweight, and more likely to have high blood pressure. In addition, after adjustment for known risk factors, periodontitis was associated with a two-fold increase in lung cancer mortality, an unexpected finding that suggests that confounding may have a strong influence. The aims of this study are: 1) to provide a systematic evaluation of potentially confounding variables in NHANES I and NHANES III; 2) to provide a systematic evaluation of the association between periodontitis and the most common causes of mortality in NHEFS, 3) to assess the benefits of using alternate referent or unexposed groups in cohort studies in NHEFS; and 4) to perform a series of sensitivity analyses to assess the extent to which confounding variables may cause spurious associations. The investigators believe the completion of these projects may play a pivotal role in determining whether the previously observed associations between periodontitis and systemic diseases are spurious or causal.