Vitamin D Status and Periodontal Disease

描述（由申请人提供）：美国人口正在老龄化，患有与年龄相关的慢性疾病（如牙周病）的老年人数量也可能增加。预防或延迟这些疾病的发病，是减低长者长期病医疗服务成本的方法之一。保持牙周组织的完整性对老年人至关重要，因为适当的牙齿健康可以使营养饮食的消费，这反过来又有助于防止其他慢性疾病的发展。维生素D缺乏和不足在美国很普遍，老年人维生素D水平低的风险特别高。由于维生素D已被证明具有免疫调节和抗微生物特性，除了对骨矿物质密度的影响外，它还可能防止牙周病的发展和进展。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，并且没有数据调查维生素D状态对牙周病进展的影响，用血液生物标志物评估。本研究的目的是调查绝经后妇女中维生素D状况与牙周病之间的关系。我们将使用之前从妇女健康倡议观察性研究（WHI OS）的布法罗临床中心进行的骨质疏松症和牙周病前瞻性辅助研究中收集的数据和血浆。这项前瞻性辅助研究的基线检查是在1997-2000年进行的，作为WHI OS 3年临床访视的补充。5年后，参与者再次被招募参加2002-2005年的随访检查。具体而言，该提案有两个主要目标：1）确定基线时用血浆25-羟基维生素D（25（OH）D）浓度评估的维生素D状态是否（1997-2000）与935名储存基线血浆的妇女基线时评估的流行牙周病相关，和2）为了确定维生素D状态，用血浆25（OH）D浓度评估，在基线时与牙周病的进展有关，在694名参加5年研究随访（2002-2005）的妇女中确定了储存的基线血浆。在两次研究访视时，进行标准化口腔检查，抽血，并收集牙周病特定的风险因素数据。此外，在两次访视中，收集了有关饮食、补充剂和药物使用以及其他因素（包括生活习惯和病史）的详细数据。该数据集包含一个独特的详细的口腔检查与牙槽嵴骨高度（ACH）的信息，确定从口内X光片，探测深度（PD）和临床附着丧失（CAL）的措施。这项研究将促进我们对维生素D状况与牙周病患病率和进展的关系的理解。如果维生素D状态被确定为一个危险因素，这可能会对老年人的牙齿和整体健康产生重大影响。 公共卫生相关性：牙周病在美国老龄人口中非常普遍。保持足够的维生素D状态可能对预防或延迟牙周病的进展有显着影响，因为它具有抗炎和抗菌特性。本研究的主要目的是通过一项对绝经后老年妇女的纵向研究，探讨牙周病的流行和进展与维生素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.