PERIODONTITIS AND SYSTEMIC DISEASE: CONFOUNDING?

牙周炎与全身性疾病有关， 心血管疾病和低出生体重。确定因果关系 这些协会是困难的;比较组，个人和 没有牙周炎，可能除了牙周炎以外的其他因素不同。如果这些 其他因素与全身性疾病风险存在因果关系，混杂因素可能是 礼物本R03提案的主要目标是提供一种方法， 通过不同的方法研究混杂。这种方法论的工作 将在三个大型数据库中进行：第一个国家卫生和 营养检查调查（NHANES I）（n = 31，973），NHANES I 流行病学随访研究（NHEFS）（n = 11，348）和第三次全国 健康和营养检查调查（NHANES III）（n = 30，818）。详尽 关于最可能混淆变量的信息， 这些数据集（每个个体超过1000个变量）。初步 NHANES I和NHEFS的分析表明，混杂是一个重要的因素， 方法上的挑战。牙周炎与意想不到的 这些差异本身可能导致其他系统性疾病。 在调整了年龄和性别后，牙周炎患者的 可能有不健康的饮食（少吃水果，少吃维生素C，少吃核黄素， 亚油酸含量更低），更有可能患上神经衰弱， 不太可能锻炼，更可能超重，更可能有 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的两倍增加有关， 这是一个意想不到的发现，表明混杂可能有很强的 影响力的社会本研究的目的是：1）提供一个系统的评价， NHANES I和NHANES III中的潜在混杂变量; 2）提供 系统评价牙周炎与大多数 NHEFS中常见的死亡原因，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） 进行一系列敏感性分析，以评估 混淆变量可能导致虚假关联。调查人员 我相信，这些项目的完成可能会在决定 先前观察到的牙周炎和全身性 疾病是虚假的或因果关系。

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.