Vitamin D Status and Periodontal Disease

描述(申请人提供)：美国的人口正在老龄化，患有与年龄相关的慢性疾病(如牙周病)的老年人数量可能也会增加。预防或延迟这类疾病的发生，是减少治疗老年人慢性病的保健服务费用的一种方法。在老年人中，保持牙周组织的完整性是至关重要的，因为适当的牙齿健康可以使人们摄入营养丰富的饮食，这反过来又有助于防止其他慢性病的发展。维生素D缺乏和不足在美国很普遍，老年人维生素D缺乏的风险特别高。由于维生素D已被证明具有免疫调节和抗微生物特性，除了对骨密度的影响外，它还可能预防牙周病的发生和发展。到目前为止，关于维生素D状态作为牙周病危险因素的作用的数据有限，还没有数据调查用血液生物标记物评估的维生素D状态对牙周病进展的影响。这项建议的目的是在老年队列(年龄53-85岁)的绝经后妇女中调查维生素D状况与牙周病之间的关系。我们将使用妇女健康倡议观察性研究(WHI OS)布法罗临床中心内进行的一项关于骨质疏松症和牙周病的前瞻性辅助研究的数据和血浆。这项前瞻性辅助研究的基线检查是在1997年至2000年期间进行的，作为对WHI OS 3年临床访问的补充。5年后，参与者再次被招募参加2002-2005年的后续测试。具体地说，这项建议有两个主要目的：1)确定在基线(1997-2000年)用血浆25-羟基维生素D(25(OH)D)浓度评估的维生素D状况是否与在基线评估的935名妇女中的牙周病流行有关，以及2)确定基线用血浆25(OH)D浓度评估的维生素D状况是否与牙周病的进展有关，694名参加了为期5年的研究(2002-2005年)的妇女用储存的基线血浆进行随访。在两次研究访问中，都进行了标准化的口腔检查，抽取了血液，并收集了特定于牙周病的危险因素数据。此外，在两次访问中，都收集了关于饮食、补充剂和药物使用的详细数据，以及包括生活习惯和病史在内的其他因素。该数据集包含唯一详细的口腔检查，其中包含有关牙槽骨顶骨高度(ACH)的信息，这些信息是通过口腔内X线片、探查深度(PD)和临床附着丧失(CAL)确定的。这项研究将促进我们对维生素D状态与牙周病流行和进展关系的理解。如果维生素D状态被确定为一个危险因素，这可能会对老龄化人口的牙科和整体健康产生重大影响。 公共卫生相关性：牙周病在美国老龄化人口中非常普遍。保持足够的维生素D状态可能会对预防或延缓牙周病的进展产生重大影响，因为它具有抗炎和抗微生物的特性。这项研究的主要目的是在一项关于绝经后老年妇女的纵向研究中，调查流行和进行性牙周病与维生素D状况之间的关系。

DESCRIPTION (provided by applicant): The population of the United States is aging and the number of elderly with age-related chronic disease, such as periodontal disease, is likely to increase as well. Prevention or delaying the onset of such diseases is one way to reduce the costs incurred by health care services for treatment of chronic disease of the elderly. Maintaining the integrity of the periodontium is of essential importance in older populations as proper dental health enables consumption of a nutritious diet, which in turn helps prevent development of other chronic diseases. Vitamin D deficiency and insufficiency is prevalent in the United States, and the elderly are at a particular increased risk of having low vitamin D status. As vitamin D has been shown to have both immune modulating and anti-microbial properties, in addition to its effects on bone mineral density, it could potentially protect against development and progression of periodontal disease. To date, limited data exists on the role of vitamin D status as a risk factor for periodontal disease, and no data has investigated the effect of vitamin D status, assessed with a blood biomarker, on progression of periodontal disease. The purpose of this proposal is to investigate associations between vitamin D status and periodontal disease in an aging cohort (aged 53-85 years) of postmenopausal women. We will use previously collected data and plasma from a prospective ancillary study on osteoporosis and periodontal disease conducted within the Buffalo clinic center of the Women's Health Initiative Observational Study (WHI OS). The baseline examination of this prospective ancillary study was conducted from 1997-2000 as an addition to the WHI OS 3 year clinic visit. The participants were then recruited again 5 years later for a follow-up exam from 2002-2005. Specifically, this proposal has two main aims: 1) To determine whether vitamin D status, assessed with plasma 25- hydroxyvitamin D (25(OH)D) concentrations, at baseline (1997-2000) is associated with prevalent periodontal disease assessed at baseline among 935 women with stored baseline plasma, and 2) To determine whether vitamin D status, assessed with plasma 25(OH)D concentrations, at baseline is associated with progressive of periodontal disease determined among 694 women attending the 5-year study follow-up (2002-2005) with stored baseline plasma. At both study visits a standardized oral examination was conducted, blood was drawn, and risk factor data specific to periodontal disease were collected. Additionally, at both visits, detailed data on diet, supplement and medication use, and other factors including lifestyle habits and medical history were collected. This dataset contains a uniquely detailed oral examination with information on alveolar crestal bone height (ACH), determined from intraoral radiographs, measures of probing depth (PD) and clinical attachment loss (CAL). This study will advance our understanding of vitamin D status in relation to periodontal disease prevalence and progression. If vitamin D status is determined to be a risk factor, this could potentially have a significant impact on the dental and overall health of aging populations. PUBLIC HEALTH RELEVANCE: Periodontal disease is highly prevalent in the US aging population. Maintaining adequate vitamin D status may have a significant impact on preventing or delaying progression of periodontal disease due to its proposed anti- inflammatory and anti-microbial properties. The main purpose of this study is to investigate associations between prevalent and progressive periodontal disease and vitamin D status in a longitudinal study of aging post-menopausal women.