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Hopkins S, Gajagowni S, Qadeer Y, Wang Z, Virani SS, Meurman JH, Leischik R, Lavie CJ, Strauss M, Krittanawong C. More than just teeth: How oral health can affect the heart. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 43:100407. [PMID: 38873102 PMCID: PMC11169959 DOI: 10.1016/j.ahjo.2024.100407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024]
Abstract
Epidemiological evidence has revealed a potential relationship between periodontal disease and cardiovascular disease (CVD). Consensus regarding a link between these pathologies remains elusive, however, largely secondary to the considerable overlap between risk factors and comorbidities common to both disease processes. This review article aims to update the evidence for an association by summarizing the evidence for causality between periodontitis and comorbidities linked to CVD, including endocarditis, hypertension (HTN), atrial fibrillation (AF), coronary artery disease (CAD), diabetes mellitus (DM) and hyperlipidemia (HLD). This article additionally discusses the role for periodontal therapy to improved management of the comorbidities, with the larger goal of examining the value of periodontal therapy on reduction of CVD risk. In doing so, we endeavor to further the understanding of the commonality between periodontitis, and CVD.
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Affiliation(s)
- Steven Hopkins
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Yusuf Qadeer
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Salim S. Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Office of the Vice Provost (Research), The Aga Khan University, Karachi 74800, Pakistan
| | - Jukka H. Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Roman Leischik
- Department of Cardiology, Sector Preventive Medicine, Health Promotion, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA
| | - Markus Strauss
- Department of Cardiology, Sector Preventive Medicine, Health Promotion, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
- Department of Cardiology I- Coronary and Periphal Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, 48149 Muenster, Germany
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Caloian CS, Șurlin P, Ciurea A, Pop D, Caloian B, Leucuța DC, Țigu AB, Rasperini G, Micu IC, Stanomir A, Soancă A, Roman A. Exploring Periodontal Conditions, Salivary Markers, and Systemic Inflammation in Patients with Cardiovascular Diseases. Biomedicines 2024; 12:1341. [PMID: 38927548 DOI: 10.3390/biomedicines12061341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: This cross-sectional investigation appreciated the role of serum C-reactive protein (CRP), several hematologic-cell markers, and salivary inflammation-related molecules [calprotectin (S100A8/A9), interleukin-1β (IL-1β), kallikrein] to predict periodontitis in patients with atherosclerotic cardiovascular disease (ACVD), arrhythmia, or both. Also, we appreciated the relationship between the inflammatory burden and periodontal destruction with the type of cardiac pathology. (2) Methods: Demographic, behavioral characteristics, periodontal indicators, blood parameters, and saliva samples were collected. (3) Results: All 148 patients exhibited stage II or III/IV periodontitis. Stage III/IV cases exhibited significantly increased S100A8/A9 levels (p = 0.004). A positive correlation between S100A8/A9 and IL-1β [0.35 (<0.001)], kallikrein [0.55 (<0.001)], and CRP [0.28 (<0.001)] was observed. Patients with complex cardiac involvement had a significantly higher number of sites with attachment loss ≥ 5 mm [19 (3-30)] compared to individuals with only arrhythmia [9 (3.25-18)] or ACVD [5 (1-12)] [0.048♦ {0.162/0.496/0.14}]. (4) Conclusions: Severe, extensive attachment loss may be indicative of patients with complex cardiac conditions, which underscores the essential role of periodontal status in relation to systemic diseases. The correlations between the rising trends of the inflammatory parameters suggest a potential interconnection between oral and systemic inflammation.
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Affiliation(s)
- Carmen Silvia Caloian
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Dana Pop
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
- Department of Cardiology-Rehabilitation, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 4000347 Cluj-Napoca, Romania
| | - Bogdan Caloian
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
- Department of Cardiology-Rehabilitation, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 4000347 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Adrian Bogdan Țigu
- Research Centre for Advanced Medicine (MEDFUTURE), Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Via della Commenda 12, 20122 Milan, Italy
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Alina Stanomir
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
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Bertoldi C, Salvatori R, Pinti M, Mattioli AV. Could the periodontal therapy improve the cardiologic patient health? A narrative review. Curr Probl Cardiol 2024; 49:102699. [PMID: 38852913 DOI: 10.1016/j.cpcardiol.2024.102699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Cardiovascular diseases (CVD) is the major cause of mortality globally, with increasing evidence suggesting a link between periodontitis, and CVD. This study aims to explore the association between periodontitis and CVD, and the impact of periodontal therapy on cardiovascular health. METHODS This review synthesized findings from preclinical and clinical studies, without publication year restrictions, examining periodontitis and CVD through various lenses. Scientific databases were inspected with keywords related to periodontitis and CVD. RESULTS The review identifies a substantial association between periodontitis and an increased risk of several CVD, supported by both epidemiological and interventional studies. Results suggest the complexity of the relationship, influenced by factors like the severity of periodontitis and the presence of other systemic conditions. Clinical data indicates that periodontal therapy, particularly non-surgical periodontal therapy, may reduce systemic inflammatory markers and thus may play a role in the primary and secondary prevention of CVD events, highlighting the potential of periodontal therapy to not only maintain oral health but also to modulate cardiovascular risk factors. CONCLUSIONS Current evidence supports a significant association between periodontitis and increased cardiovascular risk, promoting integrated healthcare approaches that consider oral health as a key-component of cardiovascular care and wellbeing.
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Affiliation(s)
- Carlo Bertoldi
- Department, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena MO, Italy
| | - Roberta Salvatori
- Department of Childhood and Adult Medical and Surgical Sciences, Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia, Modena MO, Italy.
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena MO, Italy
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Leelaviwat N, Kewcharoen J, Trongtorsak A, Thangjui S, Del Rio-Pertuz G, Abdelnabi M, Navaravong L. Association between periodontal disease and heart failure: a systematic review and meta-analysis. Acta Cardiol 2024; 79:405-409. [PMID: 37768121 DOI: 10.1080/00015385.2023.2259192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Affiliation(s)
- Natnicha Leelaviwat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jakrin Kewcharoen
- Division of Cardiology, Loma Linda University Health, Loma Linda, CA, USA
| | - Angkawipa Trongtorsak
- Department of Cardiovascular Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Sittinun Thangjui
- Division of Cardiology, West Virginia University, Morgantown, WV, USA
| | | | - Mahmoud Abdelnabi
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Leenhapong Navaravong
- Division of Cardiovascular Medicine, University of Utah Health, Salt Lake City, UT, USA
- Intermountain Heart Institute - Utah Valley, Provo, UT, USA
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Altamura S, Del Pinto R, Pietropaoli D, Ferri C. Oral health as a modifiable risk factor for cardiovascular diseases. Trends Cardiovasc Med 2024; 34:267-275. [PMID: 36963476 PMCID: PMC10517086 DOI: 10.1016/j.tcm.2023.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide with a high socioeconomic burden. Increasing evidence supports a convincing connection with increased cardiovascular risk of periodontal diseases (PD), a group of widespread, debilitating, and costly dysbiotic relapsing-remitting inflammatory diseases of the tissues supporting the teeth. Herein, we ensembled the best available evidence on the connection between CVDs and PD to review the recently emerging concept of the latter as a non-traditional risk factor for CVDs. We focused on oral dysbiosis, inflammation-associated molecular and cellular mechanisms, and epigenetic changes as potential causative links between PD and CVDs. The available evidence on the effects of periodontal treatment on cardiovascular risk factors and diseases was also described.
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Affiliation(s)
- Serena Altamura
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Center of Oral Diseases, Prevention and Translational Research - Dental Clinic, L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; PhD School in Medicine and Public Health
| | - Rita Del Pinto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
| | - Davide Pietropaoli
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Center of Oral Diseases, Prevention and Translational Research - Dental Clinic, L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy.
| | - Claudio Ferri
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
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Miyauchi S, Ouhara K, Shintani T, Tokuyama T, Okubo Y, Okamura S, Miyamoto S, Oguri N, Uotani Y, Takemura T, Tari M, Hiyama T, Miyauchi M, Kajiya M, Mizuno N, Nakano Y. Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation. J Am Heart Assoc 2024; 13:e033740. [PMID: 38597139 DOI: 10.1161/jaha.123.033740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Periodontitis has not been recognized as a modifiable risk factor for atrial fibrillation (AF). This prospective nonrandomized study investigated whether periodontal treatment improves the AF ablation outcome. METHODS AND RESULTS We prospectively enrolled 288 AF patients scheduled to undergo initial radiofrequency catheter ablation. Each patient underwent periodontal inflamed surface area (PISA; a quantitative index of periodontal inflammation) measurement. All eligible patients were recommended to receive periodontal treatment within the blanking period, and 97 consented. During the mean follow-up period of 507±256 days, 70 (24%) AF recurrences were documented. Patients who exhibited AF recurrences had a higher PISA than those who did not (456.8±403.5 versus 277.7±259.0 mm2, P=0.001). These patients were categorized into high-PISA (>615 mm2) and low-PISA (<615 mm2) groups according to the receiver operating characteristic analysis for AF recurrence (area under the curve, 0.611; sensitivity, 39%; specificity, 89%). A high PISA, as well as female sex, AF duration, and left atrial volume, were the statistically significant predicter for AF recurrence (hazard ratio [HR], 2.308 [95% CI, 1.234-4.315]; P=0.009). In patients with a high PISA, those who underwent periodontal treatment showed significantly fewer AF recurrences (P=0.01, log-rank test). The adjusted HR of periodontal treatment for AF recurrence was 0.393 (95% CI, 0.215-0.719; P=0.002). CONCLUSIONS Periodontitis may serve as a modifiable risk factor for AF. PISA is a hallmark of AF recurrence, and periodontal treatment improves the AF ablation outcome, especially for those with poor periodontal condition.
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Affiliation(s)
- Shunsuke Miyauchi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
- Division of Medicine, Health Service Center Hiroshima University Higashihiroshima Japan
| | - Kazuhisa Ouhara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Tomoaki Shintani
- Center for Oral Clinical Examination Hiroshima University Hospital Hiroshima Japan
| | - Takehito Tokuyama
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Yousaku Okubo
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Sho Okamura
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Shogo Miyamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Naoto Oguri
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Yukimi Uotani
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Tasuku Takemura
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Misako Tari
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Toru Hiyama
- Division of Medicine, Health Service Center Hiroshima University Higashihiroshima Japan
| | - Mutsumi Miyauchi
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Mikihito Kajiya
- Center for Oral Clinical Examination Hiroshima University Hospital Hiroshima Japan
| | - Noriyoshi Mizuno
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
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7
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Kim D, Kim HJ, Song TJ. Association of body composition indices with cardiovascular outcomes: a nationwide cohort study. Am J Clin Nutr 2024; 119:876-884. [PMID: 38408726 DOI: 10.1016/j.ajcnut.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/03/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Previous studies regarding BMI (kg/m2) and associated cardiovascular outcomes yield inconsistent results. OBJECTIVES We aimed to investigate the association between body composition and cardiovascular outcomes according to BMI categories in the Korean general population. METHODS A total of 2,604,401 participants were enrolled in this nationwide cohort study using the National Health Insurance Service-Health Checkup data set. Predicted lean BMI (pLBMI), body fat mass index (pBFMI), and appendicular skeletal muscle mass index (pASMMI) were calculated using validated anthropometric prediction equations. A multivariable time-dependent Cox regression analysis was conducted to assess the association with cardiovascular outcomes. The results were presented with adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), considering BMI categories (BMI < 18.5, BMI 18.5-24.9, BMI 25-29.9, and BMI ≥ 30). RESULTS Higher pLBMI and pASMMI were correlated with a reduced risk of composite cardiovascular outcomes. For pLBMI, HR was 0.910 (95% CI: 0.908, 0.913, P < 0.001) for males and 0.905 (95% CI: 0.899, 0.910, P < 0.001) for females. For pASMMI, HR was 0.825 (95% CI: 0.820, 0.829, P < 0.001) for males and 0.788 (95% CI: 0.777, 0.800, P < 0.001) for females. Conversely, a higher pBFMI was associated with an increased risk, with HR of 1.082 (95% CI: 1.071, 1.093, P < 0.001) for males and 1.181 (95% CI: 1.170, 1.192, P < 0.001) for females. Subgroup analysis based on BMI categories revealed no significant risk association for pBFMI in the BMI < 18.5 group. In the group with BMI ≥ 30, neither pLBMI nor pASMMI demonstrated a significant risk association. CONCLUSIONS Our results highlight the value of pLBMI, pBFMI, and pASMMI as variables for assessing risk of composite cardiovascular outcomes. The significance of indicators may vary depending on BMI categories.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Kim
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
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Liu Y, Qin H, Li T, Feng C, Han H, Cao Y, Su Y, He H, Yuan C, Sun M, Clarke R, Gan W, Tonetti M, Zong G. Denture use and risk for cardiometabolic disease: observational and Mendelian randomization analyses. Eur J Prev Cardiol 2024; 31:13-20. [PMID: 37697428 PMCID: PMC10767255 DOI: 10.1093/eurjpc/zwad295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/13/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023]
Abstract
AIMS Denture use may potentially increase the risk of cardiometabolic diseases (CMDs), but the casual relevance and strength of the associations are currently unknown. METHODS AND RESULTS A total of 495 938 participants from the UK Biobank were included in the observational analyses. Linkage disequilibrium score (LDSC) regression and Mendelian randomization analyses were employed to estimate genetic correlation and the associations between the genetic liability for denture use with coronary artery disease, myocardial infarction, heart failure (HF), any stroke (AS), ischaemic stroke, haemorrhagic stroke, type 2 diabetes (T2D), and related clinical risk factors. In observational analysis, denture use was associated with 14-25% higher risks of various CMDs. The LDSC analysis found that denture use showed a positive genetic correlation with CMDs (rg 0.21-0.38). Genetic liability for denture use was associated with an elevated risk of HF [odds ratio: 1.49 (1.20-1.83)] and T2D [1.11 (1.01-1.24)]. By integrating genetic summary data of denture use with the sum of decayed, missing, and filled tooth surfaces (DMFS), a clinical measure of dental caries obtained from an independent source, genetically determined denture use/DMFS was also associated with an elevated risk of AS [1.21 (1.04-1.40)]. Furthermore, genetically predicted denture use/DMFS was significantly associated with established cardiometabolic risk factors, including HDL cholesterol, triglycerides, waist circumference, waist-to-hip ratio, and height. CONCLUSION Our study supported potential causal associations between the genetic liability for denture use and risks for HF, AS, T2D, and related clinical risk factors. These findings may inform prevention and intervention strategies targeting dental diseases and CMDs.
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Affiliation(s)
- Yunan Liu
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Haiqiang Qin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Tongtong Li
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Chengwu Feng
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Han Han
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Yaying Cao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Yang Su
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Haihao He
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Changzheng Yuan
- Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou, Zhejiang 310058, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Meng Sun
- NHS Blood and Transplant (NHSBT) Blood Donor Centre, John Radcliffe Hospital, Oxford OX39BQ, UK
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX37LF, UK
- Medical Research Council, Population Health Research Unit, University of Oxford, Old Road Campus, Headington, Oxford OX37LF, UK
| | - Wei Gan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX37LF, UK
- Medical Research Council, Population Health Research Unit, University of Oxford, Old Road Campus, Headington, Oxford OX37LF, UK
- Genetics Department, Novo Nordisk Research Centre Oxford, Innovation Building, Old Road Campus, Headington, Oxford OX37LQ, UK
| | - Maurizio Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Centre for Oral Diseases, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China
- European Research Group on Periodontology, WTC Tower Genoa, Via De Marini, 1-16149 Genoa, Italy
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233, China
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Liu Y, Wang C, Zhang P, Fu W, Zhang J, Zhang Z, Mao J, Yang Y, Zou L. Association Between the Frequency of Tooth Brushing and the Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis. Angiology 2024:33197231219836. [PMID: 38179951 DOI: 10.1177/00033197231219836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Several epidemiological studies suggested that frequency of tooth brushing may be associated with cardiovascular disease (CVD) risk, but the results remain inconclusive. Therefore, the aim of this study was to synthesize frequency of tooth brushing and CVD risk using meta-analysis. Science Direct, PubMed, CINAHL, and OVID were searched through October 15, 2022. The random-effects model was used to quantitatively assess the combined risk estimation. In addition, we performed the sensitivity analysis to evaluate the robustness of the study results by excluding the included studies one by one. A total of 9 cohort studies containing 10 reports with 803,019 individuals were included in the meta-analysis. Pooled results showed that compared with the lowest brushing frequency, the highest brushing frequency (relative risk = 0.85, 95% confidence interval: 0.80-0.90) significantly reduced the risk of cardiovascular disease. There was moderate heterogeneity among included studies (P = .002, I2 = 65.4%). The exclusion of any one study did not materially change the combined risk estimates. Our meta-analysis supported the hypothesis that higher frequency of tooth brushing can reduce the risk of CVD, which may have important implications for conducting research on the prevention strategies of CVD.
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Affiliation(s)
- Yifang Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wang
- School of Public Health, Wuhan University, Wuhan, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zeyu Zhang
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Yang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Kaneyasu Y, Shigeishi H, Sugiyama M, Ohta K. Development and evaluation of the "Toothbrushing Timer with Information on Toothbrushes" application: A prospective cohort pilot study. Clin Exp Dent Res 2023; 9:1206-1213. [PMID: 37872887 PMCID: PMC10728532 DOI: 10.1002/cre2.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/29/2023] [Accepted: 09/22/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVES For people, it is challenging to be conscious of the appropriate toothbrushing time to maintain good oral health in daily life. The aim of this study was to preliminarily examine the utility of an application (app) that combines a toothbrushing timer and information on toothbrushes. MATERIALS AND METHODS We developed the "Toothbrushing Timer with Information on Toothbrushes" app to help users ensure appropriate toothbrushing time and learn about the beneficial characteristics of toothbrushes. A total of 18 participants were registered for the study. At baseline (T0) and after 1 month (T1) of app usage, study participants answered a digital questionnaire that comprised three questions on oral health practice, self-efficacy in oral hygiene, and quality of life related to oral health (Oral Health Impact Profile-14 [OHIP-14]). RESULTS Five participants were excluded from the analysis as they did not answer the digital questionnaire. Finally, 13 participants completed the survey with a follow-up of 1 month. The 13 participants were grouped into health professionals (n = 8) and non-health professionals (n = 5). The total scores for oral health practice and self-efficacy related to oral hygiene increased after a month of app usage in health professional and non-health professional groups. However, there were no significant differences between T0 and T1 in either group. The total score of OHIP-14 was lower at T1 than at T0 in both groups. Therefore, participants showed better oral health practice, self-efficacy in oral hygiene, and quality of life related to oral health at T1 compared with that at T0. CONCLUSIONS Our app showed positive results for the users and is useful in maintaining and promoting oral health awareness and practice. However, our pilot study lacks sufficient power and did not yield significant differences. Therefore, high-quality clinical trials with larger sample sizes are warranted for further improvement and evaluation.
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Affiliation(s)
- Yoshino Kaneyasu
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masaru Sugiyama
- Department of Oral Health Sciences, Faculty of Health Care SciencesTakarazuka University of Medical and Health CareTakarazuka CityHyogoJapan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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11
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Li N, Wang L, Li L, Yang MZ, Wang QX, Bai XW, Gao F, Yuan YQ, Yu ZJ, Ren ZG. The correlation between gut microbiome and atrial fibrillation: pathophysiology and therapeutic perspectives. Mil Med Res 2023; 10:51. [PMID: 37936201 PMCID: PMC10629124 DOI: 10.1186/s40779-023-00489-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
Regulation of gut microbiota and its impact on human health is the theme of intensive research. The incidence and prevalence of atrial fibrillation (AF) are continuously escalating as the global population ages and chronic disease survival rates increase; however, the mechanisms are not entirely clarified. It is gaining awareness that alterations in the assembly, structure, and dynamics of gut microbiota are intimately engaged in the AF progression. Owing to advancements in next-generation sequencing technologies and computational strategies, researchers can explore novel linkages with the genomes, transcriptomes, proteomes, and metabolomes through parallel meta-omics approaches, rendering a panoramic view of the culture-independent microbial investigation. In this review, we summarized the evidence for a bidirectional correlation between AF and the gut microbiome. Furthermore, we proposed the concept of "gut-immune-heart" axis and addressed the direct and indirect causal roots between the gut microbiome and AF. The intricate relationship was unveiled to generate innovative microbiota-based preventive and therapeutic interventions, which shed light on a definite direction for future experiments.
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Affiliation(s)
- Na Li
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, 250000, China
| | - Ling Wang
- Department of Cardiovascular Medicine, Henan Provincial Chest Hospital, Zhengzhou, 450008, China
| | - Lei Li
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, 250000, China
| | - Meng-Zhao Yang
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, 250000, China
| | - Qing-Xiang Wang
- Department of Blood Collection, Xuchang Blood Center, Xuchang, 461000, Henan, China
| | - Xi-Wen Bai
- Nanchang University Queen Marry School, Nanchang, 330036, China
| | - Feng Gao
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, 250000, China
| | - Yi-Qiang Yuan
- Department of Cardiovascular Medicine, Henan Provincial Chest Hospital, Zhengzhou, 450008, China.
| | - Zu-Jiang Yu
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Zhi-Gang Ren
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, 250000, China.
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12
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Woo HG, Kim DH, Lee H, Kang MK, Song TJ. Association between changes in predicted body composition and occurrence of heart failure: a nationwide population study. Front Endocrinol (Lausanne) 2023; 14:1210371. [PMID: 37937051 PMCID: PMC10627176 DOI: 10.3389/fendo.2023.1210371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023] Open
Abstract
Background Large population-based studies on the association between changes in body composition and the occurrence of heart failure (HF) are rare. We aimed to determine the association between changes in body composition, including the predicted body fat mass index (pBFMI), predicted appendicular skeletal muscle mass index (pASMI), and predicted lean body mass index (pLBMI), and the occurrence of HF. Methods For present study, 2,036,940 people who consecutively underwent national health examinations from 2010~2011 (baseline period) to 2012~2013 (follow-up period) were included. The pBFMI, pASMI, and pLBMI were indirectly investigated using validated anthropometric prediction equations from the Korean National Health and Nutrition Examination Survey cohort. The outcome was defined as at least two or more claims of HF. Results During a median of 7.59 years of follow-up, 22,172 participants (event rate, 1.09%) with HF were observed. Decreased changes in the pASMI and pLBMI were associated with the occurrence of HF among males (hazard ratio [HR] 0.966, 95% confidence interval (CI) [0.944-0.988]; HR 0.939, 95%CI [0.923-0.955], respectively) and females (HR 0.924, 95%CI [0.900-0.947]; HR 0.951, 95%CI [0.939-0.963], respectively). An increased change in the pBFMI was associated with the occurrence of HF in males (HR 1.017, 95%CI [1.001-1.034]). However, paradoxically, a change in the pBFMI was associated with the occurrence of HF in females (HR 0.925, 95%CI [0.909-0.942]). Conclusion Decreased skeletal muscle mass was related to the occurrence of HF. However, the relationship between a change in fat mass and the occurrence of HF was different and even paradoxical depending on sex.
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Affiliation(s)
- Ho Geol Woo
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Dong-Hyeok Kim
- Department of Cardiology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyungwoo Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Min Kyoung Kang
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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13
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Woo HG, Kang MK, Song TJ. Association of predicted body composition with occurrence of atrial fibrillation. Front Cardiovasc Med 2023; 10:1159087. [PMID: 37881721 PMCID: PMC10595030 DOI: 10.3389/fcvm.2023.1159087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023] Open
Abstract
Background Body mass index (BMI) is insufficient evidence as a risk factor for numerous health disorders. Body composition may be more appropriate for confirming the association with cardiovascular diseases, including atrial fibrillation (AF). This study aimed to examine the association between body composition and the occurrence of AF. Methods A total of 2,673,108 participants (48.6% women) without AF at baseline from the Korean national health insurance data were included. Body composition including appendicular skeletal muscle mass, body fat mass, and lean body mass were indirectly measured through validated anthropometric prediction equations. The diagnosis of AF and comorbidities were defined. Results With a median of 9.5 (interquartile range 9.2-10.1) years' follow-up, 25,841 (0.96%) cases of incident AF were included. In multivariable analysis, higher appendicular skeletal muscle was related to low risk of AF [hazard ratio (HR) 0.829, 95% confidence interval (CI) 0.753-0.912 for men (fifth quintile) and HR 0.888, 95% CI 0.792-0.995 for women (fifth quintile)]. In contrast, a higher body fat mass [HR 1.345, 95% CI 1.221-1.483 for men (fifth quintile) and HR 1.420, 95% CI 1.274-1.591 for women (fifth quintile)] and lean body mass [HR 2.241, 95% CI 2.182-2.303 for men (fifth quintile) and HR 1.516, 95% CI 1.368-1.667 for women (fifth quintile)] were associated with the occurrence of AF. Conclusions In this study, body composition parameters were associated with the occurrence of AF. It should be noted that when appendicular skeletal muscle mass decreases and body fat mass and lean body mass increase, the risk of AF may be increased in general population except underweighted BMI group.
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Affiliation(s)
- Ho Geol Woo
- Department of Neurology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Min Kyoung Kang
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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14
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Park JH, Park MS, Kim HJ, Lee H, Kim JW, Song TJ. Better oral hygiene is associated with a reduced risk of osteoporotic fracture: a nationwide cohort study. Front Endocrinol (Lausanne) 2023; 14:1253903. [PMID: 37780632 PMCID: PMC10539647 DOI: 10.3389/fendo.2023.1253903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background The aim of this study was to examine the longitudinal association between oral health parameters and osteoporotic fracture. Methods The study included participants who received oral health screening by dentists from the National Health Screening cohort database of Korea between 2003 and 2006. The primary outcome was osteoporotic fracture occurrence, which was defined using specific international classification of diseases-10 codes; vertebral fracture (S22.0, S22.1, S32.0, S32.7, T08, M48.4, M48.5, and M49.5), hip fracture (S72.0 and S72.1), distal radius fracture (S52.5 and S52.6), and humerus fracture (S42.2 and S42.3). The presence of periodontitis and various oral health examination findings, such as missing teeth, caries, frequency of tooth brushing, and dental scaling, were analyzed using a Cox proportional hazard model to assess their association with osteoporotic fracture occurrence. Results The analysis included a total of 194,192 participants, among whom 16,683 (8.59%) developed osteoporotic fracture during a median follow-up of 10.3 years. Poor oral health status, including periodontitis (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.01-1.18, p = 0.039), a higher number of missing teeth (≥15; aHR: 1.59, 95% CI: 1.45-1.75, p < 0.001), and dental caries (≥6; aHR: 1.17, 95% CI: 1.02-1.35, p = 0.030), was associated with an increased risk of osteoporotic fracture. On the other hand, better oral hygiene behaviors such as brushing teeth frequently (≥3 times per day; aHR: 0.82, 95% CI: 0.78-0.86, p < 0.001) and having dental scaling within 1 year (aHR: 0.87, 95% CI: 0.84-0.90, p < 0.001) were negatively associated with the occurrence of osteoporotic fracture. Conclusion The study found that poor oral health, such as periodontitis, missing teeth, and dental caries, was associated with an increased risk of osteoporotic fracture. Conversely, good oral hygiene behaviors like frequent teeth brushing and dental scaling within 1 year were associated with a reduced risk. Further research is needed to confirm this association.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Moo-Seok Park
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Jun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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15
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Kang MK, Ha HJ, Jung R, Oh Y, Kim DH, Song TJ. Association of high estimated glomerular filtration rate with risk of atrial fibrillation: a nationwide cohort study. Front Med (Lausanne) 2023; 10:1207778. [PMID: 37692776 PMCID: PMC10483117 DOI: 10.3389/fmed.2023.1207778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023] Open
Abstract
Aim While the relationship between impaired kidney function and atrial fibrillation (AF) is well established, there is limited research exploring the association between elevated estimated glomerular filtration rate (eGFR) and AF development. This study aimed to examine the association between higher-than-normal eGFR and AF risk using a nationwide longitudinal study of the general population in Korea. Materials and methods This study utilized the National Health Insurance Service cohort database of Korea, analyzing data from 2,645,042 participants aged 20-79 years who underwent health examinations between 2010 and 2011. Participants with a history of end-stage renal disease, renal transplantation, and AF prior to the index date were excluded. Renal function was assessed using eGFR levels, calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Baseline characteristics were gathered through questionnaires, while comorbidities and AF occurrence outcomes were identified and validated using diagnostic codes and medication histories. The study employed Kaplan-Meier survival curves and Cox proportional hazard models to evaluate the association between eGFR and AF occurrence. Results The mean age of subjects was 48.82 ± 10.08 years. Over a median follow-up of 9.58 years, 27,469 (1.04%) AF cases were identified. The risk for AF increased in the higher-than-normal decile, as demonstrated by Kaplan-Meier survival curves (p < 0.001). The eGFR <30 mL/min/1.73 m2 group was associated with an increased risk of AF [hazard ratio (HR): 1.22, 95% confidence interval (CI) (1.01, 1.46), p = 0.039], while the eGFR >120 mL/min/1.73 m2 group was associated with a decreased risk of AF [HR: 0.88, 95% CI (0.78, 0.98), p = 0.045]. Compared to the 5th decile, the 1st [HR: 1.08, 95% CI (1.03, 1.13), p = 0.010] eGFR decile was significantly associated with an increased risk of AF, while the 10th [HR: 0.77, 95% CI (0.70, 0.85), p < 0.001] eGFR decile was significantly associated with a reduced risk of AF. Conclusion The study revealed that individuals with eGFR>120 mL/min/1.73 m2 or those falling within eGFR 10th decile (>113.41 mL/min/1.73 m2) demonstrated an inverse association linked to a reduced risk of AF. Our study suggests that general population with higher-than-normal eGFR levels may have a lower risk of developing AF.
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Affiliation(s)
- Min Kyoung Kang
- Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Hee-Jung Ha
- Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Raon Jung
- College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - YunSeo Oh
- College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Dong-Hyeok Kim
- Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Tae-Jin Song
- Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
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16
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Seedat J. The knowledge-to-action process model for knowledge translation in oral care in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e9. [PMID: 37526536 PMCID: PMC10397355 DOI: 10.4102/sajcd.v70i1.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/13/2022] [Accepted: 06/12/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Literature supports the mismatch between empirical evidence and service delivery. Given this knowledge gap, it is important that research undertaken has a theoretical foundation, considers the context and stakeholders to confirm its need and that it can be feasibly implemented and sustained. OBJECTIVES The study aimed to facilitate knowledge translation in oral care using the knowledge-to-action (K2A) process model among nurses. METHOD The study was completed in an acute hospital in South Africa. A qualitative design with ethnography incorporating video-recordings and semi-structured interviews were used. A total of 139 nurses were recruited using random purposive sampling and received training on oral care, which was monitored. Inductive thematic analysis was completed. RESULTS The model facilitated information transfer and implementation of oral care by nurses. CONCLUSION With clear directions for use and theoretical underpinning, the K2A model was well-suited to the needs of the study and stakeholders, and the complexity of the context. For challenging contexts such as public healthcare institutions in South Africa, this was ideal and critical to the success of the intervention.Contribution: When nursing managers show interest and recognise nurses for their role in implementation of interventions, the buy-in, support and sustained use of that intervention is enhanced. A model such as the K2A promotes involvement of all stakeholders (e.g. nurses and their managers) in the design and planning for implementation of an intervention, and these are critical for the successful and feasible use of the intervention.
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Affiliation(s)
- Jaishika Seedat
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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17
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Park JH, Lee H, Kim JW, Song TJ. Association between periodontal disease status and risk of atrial fibrillation: a nationwide population-based cohort study. BMC Oral Health 2023; 23:461. [PMID: 37420240 PMCID: PMC10329345 DOI: 10.1186/s12903-023-03165-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Periodontal disease can activate an immune process linked to systemic diseases, including atrial fibrillation. However, the relationship between periodontal disease and atrial fibrillation remains unclear. AIM This study aimed to investigate whether changes in periodontal disease status are associated with the risk of atrial fibrillation. METHODS Using the National Health Insurance Database Korea, participants who underwent the first oral health examination in 2003 and a second examination in 2005-2006 without a history of atrial fibrillation were included. Participants were grouped according to changes in periodontal disease status during two oral examinations: periodontal disease-free, periodontal disease-recovered, periodontal disease-developed, and periodontal disease-chronic. The outcome was the incidence of atrial fibrillation. RESULTS The study included 1,254,515 participants, with a median follow-up of 14.3 years and 25,402 (2.02%) cases of atrial fibrillation occurred. During follow-up, the risk of atrial fibrillation was highest in the periodontal disease-chronic group, followed by the periodontal disease-developed, periodontal disease-recovered, and periodontal disease-free groups (p for trend < 0.001). Moreover, recovery from periodontal disease was associated with a reduced risk of atrial fibrillation compared to a chronic periodontal disease status (Hazard ratio: 0.97, 95% Confidence interval: 0.94-0.99, p = 0.045). The development of periodontal disease was associated with an increased risk of atrial fibrillation compared to being periodontal disease-free (Hazard ratio: 1.04, 95% Confidence interval: 1.01-1.08, p = 0.035). CONCLUSION Our findings suggest that changes in periodontal disease status impact the risk of atrial fibrillation. Management of periodontal disease may help prevent atrial fibrillation.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Anyangcheon-Ro 1071, Yangcheon-Gu, Seoul, 07985 Republic of Korea
| | - Hyungwoo Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804 Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Anyangcheon-Ro 1071, Yangcheon-Gu, Seoul, 07985 Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804 Republic of Korea
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18
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Obaid Hassan A, Moreno Lopez R, Lane DA, Lip GYH, Harris RV, Mughal A, Weir C. Screening of atrial fibrillation in dental practices: a qualitative feasibility study. Expert Rev Cardiovasc Ther 2023; 21:643-649. [PMID: 37653704 DOI: 10.1080/14779072.2023.2254679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 08/07/2023] [Accepted: 08/30/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES To increase the detection of unknown atrial fibrillation (AF), general practitioners have started screening their patients using small hand-held devices. It is thought that dental settings could be utilized for screening as they have regular access to patients. The aim of this study was to explore the perceptions of dental staff of screening for AF using a hand-held electronic device in primary dental care. METHODS The research took place in one large mixed NHS and private general dental practice. Views from staff including dentists, dental therapists, dental nurses, and managers were elicited via semi-structured interviews conducted face-to-face, audio recorded, and transcribed verbatim. Interviews continued until there were no new themes or patterns emerging from the data, and thematic saturation had been achieved. RESULTS Eleven participants were interviewed. The main themes generated were methodology for screening, acceptability for screening within the practice, attitudes to screening, and implementation of screening. Overall, participants were positive about implementing AF screening in a dental practice but expressed concerns about time and remuneration. Staff also gave encouraging feedback regarding the simplicity of the portable screening device. CONCLUSIONS Participants felt that AF screening in primary care dental practices was a good concept but may be challenging to implement in NHS Dentistry, especially due to the pandemic.
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Affiliation(s)
- Amaar Obaid Hassan
- Institute of Applied Health Sciences, University of Aberdeen, United Kingdom
- Now affiliated with the Department of Orthodontics, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | | | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rebecca V Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, United Kingdom
| | - Asfa Mughal
- General Dental Practitioner, Aesthetique Dental Care, Leeds, United Kingdom
| | - Corina Weir
- Institute of Applied Health Sciences, University of Aberdeen, United Kingdom
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19
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Kim D, Kim JH, Lee H, Hong I, Chang Y, Song TJ. Association of gamma-glutamyl transferase variability with risk of osteoporotic fractures: A nationwide cohort study. PLoS One 2023; 18:e0277452. [PMID: 37267386 DOI: 10.1371/journal.pone.0277452] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/19/2023] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES Gamma-glutamyl transferase (GGT) is related to inflammation, osteoporosis, and vascular diseases. Recently, changes in metabolic parameters have been proposed as osteoporosis biomarkers. We aimed to assess longitudinally the association of GGT variability with osteoporotic fractures. METHODS From the National Health Insurance Service-Health Screening Cohort database, participants who underwent three or more health examinations between 2003 and 2008 were included (n = 1,072,432). Variability indexes were as follows: (1) coefficient of variation (CV), (2) standard deviation (SD), and (3) variability independent of the mean (VIM). The primary outcome was occurrence of osteoporotic fracture, defined as identification of one of the following international classification of diseases-10 codes: vertebral fractures (S22.0, S22.1, S32.0, S32.7, T08, M48.4, M48.5, M49.5), hip fractures (S72.0, S72.1), distal radius fractures (S52.5, S52.6), or humerus fractures (S42.2, S42.3). RESULTS During a median of 12.3 years (interquartile range 12.1-12.6), osteoporotic fractures occurred in 49,677 (4.6%) participants. In multivariable analysis, GGT variability based on CV positively correlated with the occurrence of osteoporotic fracture (adjusted hazard ratio [HR] of the highest quartile compared with the lowest quartile 1.15, 95% confidence interval [CI] 1.12-1.18, P < 0.001). These results were consistent even when GGT variability was defined by SD (adjusted HR 1.22, 95% CI 1.19-1.25, P < 0.001) and VIM (adjusted HR 1.12, 95% CI 1.09-1.15, P < 0.001). CONCLUSIONS Increased GGT variability is associated with an increased risk of osteoporotic fractures in the Korean population. Maintaining constant and stable GGT level may help reduce the risk of osteoporotic fractures.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jee Hyun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Iksun Hong
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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Kwon R, Kim HJ, Lee SW, Koyanagi A, Shin JI, Song TJ, Yon DK, Smith L. Effectiveness of famotidine on the risk of poor prognosis in patients with COVID-19: A nationwide cohort study in Korea. Heliyon 2023; 9:e16171. [PMID: 37287614 PMCID: PMC10232936 DOI: 10.1016/j.heliyon.2023.e16171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/22/2023] [Accepted: 05/08/2023] [Indexed: 06/09/2023] Open
Abstract
Objective Famotidine has been proposed as a promising candidate for the treatment of coronavirus disease 2019 (COVID-19). However, there is limited research on the association of famotidine with the poor prognosis of COVID-19. Methods The Korean nationwide cohort included 6,556 patients who tested positive on RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The poor COVID-19-related outcomes were defined on the basis of having encountered the composite outcome of high oxygen therapy, intensive care unit admission, administration of mechanical ventilation, or death. In addition, we performed exposure-driven propensity score matching for no H2-blocker use versus current famotidine use, and other H2-blocker use versus current famotidine use. Results 4,785 (73.0%) patients did not use a H2-blocker, 393 (6.0%) patients were currently used famotidine, and 1,292 (19.7%) patients currently used H2-blocker other than famotidine. In multivariable analysis after matching (no H2-blocker use versus current famotidine use), there was no significant association between current famotidine use and composite outcomes (adjusted odd ratios [aOR]: 1.30, 95% confidence interval [CI]: 0.55-3.06). On the other hand, another matched cohort (other H2-blocker use versus current famotidine use), demonstrated a positive association between current famotidine use and composite outcomes (aOR: 3.56, 95% CI: 1.03-12.28). Conclusions Our study results did not support the potential of famotidine as a therapeutic agent for COVID-19. A rather unexpected result could be observed in the comparisons between current famotidine use and other H2-blocker use; it was observed that current famotidine use increased the risk of poor COVID-19 related outcomes. Further studies are needed to clearly prove the causal relationship with several H2-blockers, including famotidine.
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Affiliation(s)
- Rosie Kwon
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyung Jun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
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Chang Y, Lee H, Song TJ. Association of gamma-glutamyl transferase variability with risk of venous thrombosis. Sci Rep 2023; 13:7402. [PMID: 37149666 PMCID: PMC10164162 DOI: 10.1038/s41598-023-34368-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/28/2023] [Indexed: 05/08/2023] Open
Abstract
Gamma-glutamyl transferase (GGT) is a biomarker of inflammation, and is known to be associated with stroke and atrial fibrillation. Venous thromboembolism (VT), a not uncommon thrombotic disorder, shares similar mechanisms with other thrombotic disorders including these stroke and atrial fibrillation. Given these associations, we intended to investigate the potential association between variability in GGT and VT. The study included data from the National Health Insurance Service-Health Screening Cohort, comprising 1,085,105 participants with health examinations 3 or more times from 2003 to 2008. Variability indexes were the coefficient of variation, standard deviation, and variability independent of the mean. The occurrence of venous thromboembolism (VT) was defined with more than one claim of the following ICD-10 codes: deep VT (I80.2-80.3), pulmonary thromboembolism (I26), intraabdominal venous thrombosis (I81, I82.2, I82.3), or other VT (I82.8, I82.9). To determine the relationship of quartiles of GGT with incident VT risk, Kaplan-Meier survival curve and logrank test were used. Cox's proportional hazard regression was used to investigate the risk of VT occurrence by GGT quartile (Q1-Q4). A total of 1,085,105 subjects were incorporated in the analysis, and the average follow-up was 12.4 years (interquartile range 12.2-12.6). VT occurred in 11,769 (1.08%) patients. The GGT level was measured 5,707,768 times in this stud. Multivariable analysis showed that GGT variability were positively associated with the occurrence of VT. Compared to the Q1, the Q4 showed an adjusted HR of 1.15 (95% CI 1.09-1.21, p < 0.001) when using coefficient of variation, 1.24 (95% CI 1.17-1.31, p < 0.001) when using standard deviation, and 1.10 (95% CI 1.05-1.16, p < 0.001) when using variability independent of the mean. Increased variability of GGT may be related to an increased risk of VT. Maintaining a stable GGT level would be beneficial in reducing the risk of VT.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, Republic of Korea.
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22
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Zhang Z, Chen F, Gao X, Xiao B, Liu F, Lu J. Effects of Oral Inflammatory Diseases and Oral Hygiene on Atrial Fibrillation: A Systematic Review. Int J Clin Pract 2023; 2023:1750981. [PMID: 37020707 PMCID: PMC10070027 DOI: 10.1155/2023/1750981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/26/2023] [Accepted: 03/11/2023] [Indexed: 03/29/2023] Open
Abstract
Objective. Research evidence suggests a link between periodontitis (PD) and atrial fibrillation, but the nature of this link is unclear. This study aimed to systematically review and evaluate the association between PD, other oral diseases, and atrial fibrillation and the role of oral hygiene in preventing atrial fibrillation. Methods. We searched the Medline, Embase, Cochrane Library, and Web of Science databases for the clinical study of oral health and atrial fibrillation from inception to November 2022. Oral health conditions included PD and other oral inflammatory diseases, regular oral hygiene, and tooth brushing. The primary outcomes were the risk of new-onset atrial fibrillation in patients with oral disease, the effect of regular oral care on preventing atrial fibrillation, the effect of frequent tooth brushing on preventing atrial fibrillation, and the incidence of atrial fibrillation in PD patients. Results. Eight clinical trials with a total of 4,328,355 patients were included. The result of the research showed that PD and other impaired oral health may be associated with new-onset atrial fibrillation, and its severity was dose-responsive to the risk of atrial fibrillation. The incidence of atrial fibrillation in patients with severe PD was about 16.3%. Moreover, PD may increase the risk of long-term arrhythmia in patients with atrial fibrillation. Regular oral care and frequent tooth brushing can reduce the incidence of atrial fibrillation. Conclusion. Regular and moderate oral hygiene, frequent tooth brushing, and prevention of PD and other oral inflammatory diseases could reduce the occurrence of atrial fibrillation. It is recommended to strengthen the popularization of oral health knowledge in the publicity related to atrial fibrillation.
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Chang Y, Chung MK, Park JH, Song TJ. Association of Oral Health with Risk of Rheumatoid Arthritis: A Nationwide Cohort Study. J Pers Med 2023; 13:jpm13020340. [PMID: 36836574 PMCID: PMC9960411 DOI: 10.3390/jpm13020340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
Periodontitis and rheumatoid arthritis (RA) are inflammatory diseases that share many similarities. We aimed to investigate the associations of periodontitis and oral hygiene status and behaviors with RA in a nationwide general population cohort. Participants from the National Health Screening cohort database of Korea who underwent oral health screening by dentists between 2003 and 2004 were included. The occurrence of RA was analyzed according to the presence of periodontitis, oral health examination findings, and behaviors. Overall, 2,239,586 participants were included. During a median of 16.7 years, RA occurred in 27,029 (1.2%) participants. The risk for incident RA was higher when participants had periodontitis (hazard ratio (HR) 1.2, 95% confidence interval (CI), 1.08-1.24) and an increased number of missing teeth (HR 1.5, 95% CI, 1.38-1.69). In contrast, better oral hygiene behaviors, such as a higher frequency of daily tooth brushing (HR 0.76, 95% CI 0.73-0.79, p for trend <0.001) and a recent history of dental scaling (HR 0.96, 95% CI 0.94-0.99), were associated with a lower occurrence of RA. Periodontitis and increased missing teeth were associated with an increased risk of RA. Maintaining good oral hygiene through frequent tooth brushing and regular dental scaling may reduce the risk of RA occurrence.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Min Kyung Chung
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Correspondence: ; Tel.: +82-2-6986-1672
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Chang Y, Kim SH, Jeon J, Song TJ, Kim J. Oral Health and Risk of Retinal Vascular Occlusions: A Nationwide Cohort Study. J Pers Med 2023; 13:jpm13010121. [PMID: 36675781 PMCID: PMC9862611 DOI: 10.3390/jpm13010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/01/2023] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
Retinal vascular occlusions are a common cause of visual loss. The association between oral health and the risk of retinal vascular occlusions remains unknown. We investigated whether oral health was associated with the risk of retinal vascular occlusions. We conducted a retrospective cohort study including 138,484 participants who completed a national health screening program with an oral health examination from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) 2002-2015. Oral health markers, such as the presence of periodontitis, tooth loss, and dental caries, and the frequency of daily tooth brushing, were evaluated. The primary outcome was the occurrence of retinal vascular occlusions up to December 2015. In total, 2533 participants developed retinal vascular occlusions (215 with retinal artery occlusion, 1686 with retinal vein occlusion, 632 with unspecified retinal vascular occlusion). In the multivariable Cox regression analysis, periodontitis was an independent risk factor for retinal vascular occlusions (adjusted hazard ratio: 1.18; 95% confidence interval: 1.02-1.36; p = 0.024). Frequent tooth brushing was negatively associated with the risk of retinal vascular occlusions (adjusted hazard ratio: 0.89; 95% confidence interval: 0.80-0.98; p = 0.022). Improving oral hygiene may contribute to the attenuation of the risk of retinal vascular occlusions.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea
| | - Sung-Hee Kim
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si 16995, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
- Correspondence: (T.-J.S.); (J.K.); Tel.: +82-2-6986-1672 (T.-J.S.); +82-31-5189-8152 (J.K.)
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si 16995, Republic of Korea
- Correspondence: (T.-J.S.); (J.K.); Tel.: +82-2-6986-1672 (T.-J.S.); +82-31-5189-8152 (J.K.)
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Park JH, Lee H, Kim JW, Song TJ. Better oral hygiene is associated with a reduced risk of cataract: A nationwide cohort study. Front Med (Lausanne) 2023; 9:1036785. [PMID: 36660000 PMCID: PMC9842665 DOI: 10.3389/fmed.2022.1036785] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/02/2022] [Indexed: 01/04/2023] Open
Abstract
Objective To investigate the association of oral health status and oral hygiene behaviors with cataract occurrence longitudinally. Materials and methods Based on the National Health Screening cohort database of Korea, participants who underwent oral health screening by dentists in 2003 were included. Cataract was defined as two or more claims of disease classification for the International Classification of Diseases-10 (E10.34, E11.34, E12.34, E13.34, E14.34, H25, and H26) with cataract specific treatment or surgery procedure claim codes. The occurrence of cataract was analyzed with Cox proportional hazard model according to the presence of periodontitis and oral health examination findings, including missing teeth, caries, tooth brushing, and dental scaling. Results Overall, 103,619 subjects were included. During a median follow-up of 12.2 years, cataract developed in 12,114 (11.7%) participants. Poor oral health status such as the presence of periodontitis (adjusted hazard ratio [HR] 1.08, 95% CI [confidence interval] 0.99-1.17, p = 0.088) and increased number of missing teeth (adjusted HR = 1.74, 95% CI = 1.55-1.96, p < 0.001) was associated with the increased cataract risk. Better oral hygiene behaviors such as increased frequency of tooth brushing (adjusted HR = 0.84, 95% CI = 0.79-0.88, p < 0.001) and performed dental scaling within 1 year (adjusted HR = 0.90, 95% CI = 0.86-0.94, p < 0.001) were negatively associated with cataract occurrence. Conclusion Periodontitis and increased number of missing teeth may increase the risk of cataract. However, maintaining good oral hygiene through tooth brushing and dental scaling may reduce the risk of future cataract occurrence. Further studies should be performed to confirm the association between chronic oral inflammation and cataract.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea,*Correspondence: Tae-Jin Song,
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Miyauchi S, Nishi H, Ouhara K, Tokuyama T, Okubo Y, Okamura S, Miyamoto S, Oguri N, Uotani Y, Takasaki T, Katayama K, Furusho H, Miyauchi M, Takahashi S, Hiyama T, Nakano Y. Relationship Between Periodontitis and Atrial Fibrosis in Atrial Fibrillation: Histological Evaluation of Left Atrial Appendages. JACC Clin Electrophysiol 2023; 9:43-53. [PMID: 36697200 DOI: 10.1016/j.jacep.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Atrial fibrosis contributes to the onset and persistence of atrial fibrillation (AF) and AF-related stroke. Periodontitis, a common infectious and inflammatory disease, aggravates some systemic diseases. However, the association of periodontitis with AF and with atrial fibrosis has remained unclarified. OBJECTIVES The authors aimed to elucidate the relationship between periodontitis and atrial fibrosis by studying resected left atrial appendages (LAAs). METHODS Seventy-six patients with AF (55 with nonparoxysmal AF, 25 with mitral valve regurgitation, 18 with LAA thrombus) who were scheduled to undergo LAA excision during cardiac surgery were prospectively enrolled. All patients underwent an oral examination, and the remaining number of teeth, bleeding on probing, periodontal probing depth, and periodontal inflamed surface area (PISA) were evaluated as parameters of periodontitis. The degree of fibrosis in each LAA was quantified by Azan-Mallory staining. RESULTS Bleeding on probing (R = 0.48; P < 0.0001), periodontal probing depth of ≥4 mm (R = 0.26; P = 0.02), and PISA (R = 0.46; P < 0.0001) were positively correlated with atrial fibrosis. Among patients with >10 remaining teeth, PISA was positively and strongly correlated with atrial fibrosis (R = 0.57; P < 0.0001). After adjustments for age, AF duration, BMI, mitral valve regurgitation, and CHADS₂ (congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack) score, PISA was significantly associated with atrial fibrosis (β = 0.016; P = 0.0002). CONCLUSIONS The authors histologically revealed the association of periodontitis with atrial fibrosis. This indicates that periodontitis, which is modifiable, is likely a risk factor for AF.
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Affiliation(s)
- Shunsuke Miyauchi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Division of Medicine, Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Hiromi Nishi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuhisa Ouhara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takehito Tokuyama
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yousaku Okubo
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sho Okamura
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Miyamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoto Oguri
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukimi Uotani
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Taiichi Takasaki
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keijiro Katayama
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hisako Furusho
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mutsumi Miyauchi
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinya Takahashi
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toru Hiyama
- Division of Medicine, Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
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Park JH, Kim JW, Lee H, Hong I, Song TJ. Better Oral Hygiene Is Associated with a Decreased Risk of Meniere's Disease: A Nationwide Cohort Study. J Pers Med 2022; 13:jpm13010080. [PMID: 36675740 PMCID: PMC9860890 DOI: 10.3390/jpm13010080] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 01/01/2023] Open
Abstract
To investigate the association of the oral health parameters with Meniere’s disease in a nationwide population-based longitudinal cohort database. The data of the participants who underwent an oral health screening by dentists in 2003 (n = 2,415,963) were retrieved from the National Health Insurance Database of the Korean National Health Insurance Service. The main outcome was the occurrence of Meniere’s disease, defined as two or more claims of the diagnostic code H810 with a previous audiometric examination. The occurrence of Meniere’s disease was analyzed using a Cox proportional hazard model according to the presence of periodontitis and the oral health examination findings, including missing teeth, the frequency of tooth brushing and dental scaling. Overall, the analysis included 2,240,282 participants. During a median follow-up of 16.7 years, Meniere’s disease developed in 112,106 (5.0%) participants. Poor oral health status was characterized by the presence of periodontitis (adjusted hazard ratio [aHR]: 1.18, 95% confidence interval [CI]: 1.14−1.22, p < 0.001) and an increased number of missing teeth (≥15; aHR: 1.25, 95% CI: 1.18−1.32, p < 0.001) was associated with an increased risk of Meniere’s disease. Better oral hygiene behaviors, such as frequent tooth brushing (≥3 per day; aHR: 0.75, 95% CI: 0.73−0.76, p < 0.001) and dental scaling within 1 year (aHR: 0.98, 95% CI: 0.97−0.99, p = 0.003) were negatively associated with the occurrence of Meniere’s disease. The presence of periodontitis and an increased number of missing teeth may augment the risk of the occurrence of Meniere’s disease. However, maintaining good oral hygiene through tooth brushing and dental scaling may be associated with a decreased risk of Meniere’s disease. Further studies should confirm the association between oral health and Meniere’s disease.
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Affiliation(s)
- Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Seoul 07985, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Seoul 07985, Republic of Korea
| | - Heajung Lee
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
| | - Iksun Hong
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
- Correspondence: ; Tel.: +82-2-6986-1672; Fax: +82-2-6986-7000
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Improved Oral Health Status Is Associated with a Lower Risk of Venous Thromboembolism: A Nationwide Cohort Study. J Pers Med 2022; 13:jpm13010020. [PMID: 36675681 PMCID: PMC9863073 DOI: 10.3390/jpm13010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Oral health is reportedly associated with several systemic diseases, particularly cardiovascular diseases, through systemic inflammatory and thrombotic mechanisms. This study aimed to investigate the association between oral health status, oral hygiene behavior, and venous thromboembolism (VTE) in a nationwide, population-based cohort database in a longitudinal setting. Data of participants who underwent oral health screening by dentists between January and December 2003 (n = 2,415,963) were retrieved from the National Health Insurance Database of the Korean National Health Insurance Service. Periodontitis was identified using claims or oral health screening data. Periodontal pockets and the number of missing teeth were examined by dentists during oral health screenings. Data on oral hygiene behaviors (tooth brushing, dental visits, and dental scaling) were collected. VTE was defined as two or more claims of one of the following ICD-10 codes: deep (I80.2−80.3), pulmonary (I26, I26.0, I26.9), intra-abdominal (I81, I82, I82.2, I82.3), and other (I82.8, I82.9) VTE and concurrent medication (anticoagulants and antiplatelets). VTE was analyzed using the Cox proportional hazard model according to periodontitis, number of missing teeth, tooth brushing frequency, dental visits, and dental scaling. VTE occurred in 39,851 (1.8%) participants within a median of 17.0 (interquartile range 16.3−17.7) years. Periodontitis was associated with VTE (adjusted hazard ratio (HR), 1.2; 95% confidence interval (CI), 1.15−1.28; p < 0.001). An increased number of missing teeth was associated with an increased risk of VTE; the adjusted HR (versus participants without missing teeth) was 1.58 (95% CI, 1.46−1.71; p < 0.001, p for trend < 0.001) for participants with ≥15 missing teeth. Furthermore, tooth brushing ≥3 times a day was negatively correlated with VTE (adjusted HR, 0.67; 95% CI, 0.65−0.69; p < 0.001, p for trend < 0.001). Dental scaling within one year was associated with a significantly lower risk of VTE (adjusted HR, 0.95; 95% CI, 0.93−0.98; p < 0.001). Improved oral hygiene, including tooth brushing and dental scaling, may be associated with a decreased risk of VTE. Periodontitis and an increased number of missing teeth may increase the risk of VTE.
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Walther C, Wenzel J, Schnabel RB, Heydecke G, Seedorf U, Beikler T, Borof K, Nikorowitsch J, Schrage B, Blankenberg S, Twerenbold R, Zeller T, Magnussen C, Aarabi G. Association between periodontitis and heart failure in the general population. ESC Heart Fail 2022; 9:4189-4197. [PMID: 36101477 PMCID: PMC9773719 DOI: 10.1002/ehf2.14150] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/12/2022] [Accepted: 09/04/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS Data on the association between periodontitis and preclinical cardiac alterations remain scarce. The aim of the current study is to determine if periodontitis is associated with morphological and functional cardiac changes measured by transthoracic echocardiography as well as different heart failure (HF) phenotypes. METHODS Participants from the population-based Hamburg City Health Study [ClinicalTrial.gov (NCT03934957)], who underwent transthoracic echocardiography and periodontal screening were included. Periodontitis was classified according to Eke and Page (none/mild, moderate, severe). The 2021 ESC HF guidelines were applied and HF was classified into HF with preserved ejection fraction (HFpEF, ejection fraction ≥50%), HF with mid-range and reduced ejection fraction [HF(m)rEF, ejection fraction <50%], and HF in general [HFpEF and HF(m)rEF]. Due to limited size, all subjects with LVEF <50% and symptoms or signs of HF were classified as HF with reduced and mildly reduced ejection fraction [HF(m)rEF]. RESULTS Within 6209 participants with full periodontal examination, we identified an overlap of n = 167 participants with periodontitis and HF. Participants with severe periodontitis showed a higher burden of cardiovascular risk factors (men at advanced age, diabetes mellitus, hypertension) when compared with participants with none/mild periodontitis. After adjustment for age, sex, body mass index, smoking, diabetes, hypertension, atrial fibrillation, and coronary artery disease, severe periodontitis was significantly associated with HF(m)rEF (odds ratio: 3.16; 95% CI: 1.21, 8.22; P = 0.019), although no association was found for HFpEF and HF in general. CONCLUSIONS The current study demonstrated that severe periodontitis was significantly associated with HF(m)rEF, although no relevant associations were found with HFpEF and HF in general as well as echocardiographic variables. The results implicate a potential target group, who need special attention from cooperating physicians and dentists. Future studies are warranted to verify whether systemic inflammation could be the link between the two diseases.
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Affiliation(s)
- Carolin Walther
- Department of Periodontics, Preventive and Restorative DentistryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Jan‐Per Wenzel
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Epidemiological Study CenterUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany
| | - Renate B. Schnabel
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/LuebeckHamburgGermany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative DentistryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative DentistryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative DentistryUniversity Medical Center Hamburg‐EppendorfHamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany
| | - Julius Nikorowitsch
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Epidemiological Study CenterUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany
| | - Benedikt Schrage
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/LuebeckHamburgGermany
| | - Stefan Blankenberg
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/LuebeckHamburgGermany
| | - Raphael Twerenbold
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Epidemiological Study CenterUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/LuebeckHamburgGermany,University Center of Cardiovascular ScienceUniversity Heart and Vascular CenterHamburgGermany
| | - Tanja Zeller
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,University Center of Cardiovascular ScienceUniversity Heart and Vascular CenterHamburgGermany
| | - Christina Magnussen
- Department of CardiologyUniversity Heart and Vascular Center Hamburg, UKE HamburgHamburgGermany,Population Health Research DepartmentUniversity Heart and Vascular Center, UKE HamburgHamburgGermany,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/LuebeckHamburgGermany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative DentistryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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Kalhan AC, Wong ML, Allen F, Gao X. Periodontal disease and systemic health: An update for medical practitioners. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:567-574. [PMID: 36189701 DOI: 10.47102/annals-acadmedsg.2021503] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Chronic periodontal disease is a highly prevalent dental condition affecting tooth-supporting tissues. Scientific evidence is accumulating on links between periodontal disease and various systemic conditions. This narrative review provides a holistic yet succinct overview that would assist medical practitioners to deliver integrated care for better clinical outcomes. METHOD Scientific evidence on associations between periodontal disease and systemic conditions was synthesised and critically appraised. Key findings of latest prospective cohort studies, randomised clinical trials, and meta-analysis were closely assessed and compiled. RESULTS A bidirectional relationship has been established, indicating that diabetes and periodontal disease are closely linked and amplify one another, if not successfully controlled. Existing evidence also supports the associations of periodontal disease with cardiovascular diseases and adverse pregnancy outcomes. Successful treatment of periodontal disease and dental prophylaxis has been shown to improve clinical outcomes in these systemic conditions. Other systemic conditions associated with periodontal disease include respiratory diseases, Alzheimer's disease, rheumatoid arthritis and chronic kidney disease. Although the underlying mechanisms remain to be fully elucidated, it is generally accepted that the inflammatory burden of chronic periodontal disease has an important systemic impact. CONCLUSION Oral-systemic links are multifaceted and complex. While evidence linking periodontal disease with a variety of systemic conditions is still emerging, the nature of the relationship is becoming clearer. The updated understanding of these associations warrants the attention of medical experts and policymakers for a concerted effort to develop a patient-centric, integrated model for the treatment of comorbid dental and medical conditions.
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Mitochondrial DNA Efflux Maintained in Gingival Fibroblasts of Patients with Periodontitis through ROS/mPTP Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1000213. [PMID: 35720188 PMCID: PMC9201712 DOI: 10.1155/2022/1000213] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/24/2022] [Indexed: 12/22/2022]
Abstract
Mitochondria have their own mitochondrial DNA (mtDNA). Aberrant mtDNA is associated with inflammatory diseases. mtDNA is believed to induce inflammation via the abnormal mtDNA release. Periodontitis is an infectious, oral inflammatory disease. Human gingival fibroblasts (HGFs) from patients with chronic periodontitis (CP) have shown to generate higher reactive oxygen species (ROS) that cause oxidative stress and have decreased mtDNA copy number. Firstly, cell-free mtDNA was identified in plasma from CP mice through qRT-PCR. Next, we investigated whether mtDNA efflux was maintained in primary cultures of HGFs from CP patients and the possible underlying mechanisms using adenovirus-mediated transduction live cell imaging and qRT-PCR analysis. Here, we reported that mtDNA was increased in plasma from the CP mice. Additionally, we confirmed that CP HGFs had significant mtDNA efflux from mitochondria compared with healthy HGFs. Furthermore, lipopolysaccharide (LPS) from Porphyromonas gingivalis can also cause mtDNA release in healthy HGFs. Mechanistically, LPS upregulated ROS levels and mitochondrial permeability transition pore (mPTP) opening by inhibition of pyruvate dehydrogenase kinase (PDK)2 expression, resulting in mtDNA release. Importantly, mtDNA efflux was even persistent in HGFs after LPS was removed and cells were passaged to the next three generations, indicating that mtDNA abnormalities were retained in HGFs in vitro, similar to the primary hosts. Taken together, our results elucidate that mtDNA efflux was maintained in HGFs from periodontitis patients through abnormal ROS/mPTP activity. Therefore, our work indicates that persistent mtDNA efflux may be a possible diagnostic and therapeutic target for patients with periodontitis.
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Hwang SY, Oh H, Rhee MY, Kang S, Kim HY. Association of periodontitis, missing teeth, and oral hygiene behaviors with the incidence of hypertension in middle-aged and older adults in Korea: A 10-year follow-up study. J Periodontol 2022; 93:1283-1293. [PMID: 35446990 DOI: 10.1002/jper.21-0706] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The relationship between periodontitis and hypertension remains controversial. This study aimed to investigate the association of periodontitis, missing teeth, and oral hygiene behaviors with the incidence of hypertension. METHODS A total of 104,349 participants were selected from the National Health Insurance System-Health Screening cohort. Incident hypertension and periodontitis were diagnosed based on the patients' clinical records and health examinations. A multivariable Cox proportional hazards regression analysis was performed after adjusting for socioeconomic factors, coexisting disease, and health behaviors. RESULTS The mean age of the participants was 51.1 years (range, 40-79 years) at baseline, and 55.1% were men. A total of 52,855 incident hypertension cases were identified during the median follow-up period of 9.6 years. Among the participants, periodontitis (hazard ratio [HR]: 1.02, 95% confidence interval [95% CI]: 1.00-1.04), number of missing teeth (for ≥15 group, HR: 1.40, 95% CI: 1.29-1.52), dental scaling (HR: 0.93, 95% CI: 0.91-0.95), and tooth brushing frequency (for ≥3 group, HR: 0.85, 95% CI: 0.83-0.88) were significantly associated with incident hypertension after full adjustments for covariates. While periodontitis was significantly associated with incident hypertension (HR: 1.04, 95% CI: 1.02-1.06) in the middle-aged group (40-64 years), the effect was insignificant in the older group (≥65 years). CONCLUSION Oral inflammation could contribute to the incidence of hypertension; thus, efforts to reduce oral inflammation should be encouraged. Future intervention studies are warranted to determine whether oral health care could be beneficial in the management of hypertension. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Su-Yeon Hwang
- Research Institute for Future Medical Science, Chungnam National University Sejong Hospital, Sejong, 30099, Korea.,Department of Public Health Sciences, Graduate School, and Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, Korea
| | - Hannah Oh
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea.,Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Korea
| | - Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang, Korea
| | - Sangwook Kang
- Department of Applied Statistics, Department of Statistics and Data Science, Yonsei University, Seoul, Korea
| | - Hae-Young Kim
- Department of Public Health Sciences, Graduate School, and Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, Korea.,Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
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Hiramatsu T, Okumura S, Iguchi D, Kojima H. Higher dental care is positively associated with key prognosis factors in peritoneal dialysis patients: findings from a retrospective study. RENAL REPLACEMENT THERAPY 2022. [DOI: 10.1186/s41100-021-00389-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Oral disease may be increased in people with end-stage renal disease and associated with inflammation, cardiovascular disease, and mortality. Moreover, oral disease may be essential to decide the prognosis of peritoneal dialysis (PD) patients. However, only a few reports have explored the effects of dental care (DC) on cardiovascular diseases and mortality in PD patients. Thus, we aimed to investigate the association of DC with the prognosis of PD patients.
Methods
In this single-center, retrospective study, we enrolled 165 incident PD patients aged ≥ 20 years. We classified patients based on their dental care score, assessed using a self-reported questionnaire into the better dental care group (Group A, score ≥ 7) or the worse dental care group (Group B, score < 7). Demographic, clinical, hospitalization, hospital admission, comorbidities (including congestive heart failure, acute coronary syndrome, stroke, peripheral artery disease, and pneumonia), and mortality (including specific causes) data were extracted from the patient’s medical records. Data were analyzed using one-way ANOVA, Wilcoxon t-test, Kruskal–Wallis, Mann–Whitney U-test, chi-square test, Fisher’s exact test and multiple regression when appropriate. We compared the survival distributions among groups using the long-rank test.
Results
Of the 165 patients, 75 were allocated to group A and 90 to group B. PD patients with better dental care (group A) had significantly lower levels of C-reactive protein (CRP) and higher levels of serum albumin compared to PD patients with worse dental care (group B). Hospital admissions due to congestive heart failure, acute coronary syndrome, pneumonia, and peritonitis were also lower in group A than group B. Mortality rates due to congestive heart failure, acute coronary syndrome, pneumonia, and sepsis were lower in group A than in group B.
Conclusions
The study highlights the importance of good dental care, particularly for PD patients. Nephrologists and dental professions should design and implement oral health education strategies to improve PD patients’ dental care.
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Leelapatana P, Limpuangthip N. Association between oral health and atrial fibrillation: A systematic review. Heliyon 2022; 8:e09161. [PMID: 35846443 PMCID: PMC9280496 DOI: 10.1016/j.heliyon.2022.e09161] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/11/2021] [Accepted: 03/18/2022] [Indexed: 10/28/2022] Open
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Kim J, Kim HJ, Jeon J, Song TJ. Association between oral health and cardiovascular outcomes in patients with hypertension: a nationwide cohort study. J Hypertens 2022; 40:374-381. [PMID: 34670996 DOI: 10.1097/hjh.0000000000003022] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Studies on the association of oral hygiene indicators with cardiovascular disease in hypertensive patients have been lacking. Oral hygiene is directly or indirectly associated with systemic inflammation, one of the essential mechanisms of cardiovascular disease. Therefore, we hypothesized that oral hygiene would be related to the risk of cardiovascular diseases in hypertensive patients. METHODS We included 52 677 hypertensive participants who completed oral health checkups from the Korean National Health Insurance Service-National Health Screening Cohort between 2003 and 2004. We collected data on periodontitis diagnosis and treatment history, number of teeth loss, number of dental caries, and frequency of tooth brushing from medical records of health claims and oral health examination. The primary outcome was defined as composite outcomes of stroke and myocardial infarction. Follow-up was done until the date of primary outcome, or 31 December 2015. RESULTS During the 11.26 ± 2.39 years (mean ± standard deviation) of the study follow-up, 3292 participants developed primary outcomes [stroke (n = 2430), myocardial infarction (n = 862)]. In multivariable Cox regression analyses, participants with dental caries (≥ 5) were independently associated with occurrence of a primary outcome [adjusted hazard ratio: 1.37; 95% confidence interval (CI):1.10-1.72; P = 0.006]. Frequent tooth brushing (≥ 2 times/day) was significantly related to lower risk of primary outcomes (adjusted hazard ratio: 0.88; 95% CI: 0.81-0.96; P = 0.002). CONCLUSION Our study demonstrated that multiple dental caries were related to the risk of cardiovascular diseases in hypertensive patients. Better oral hygiene may attenuate the risk of cardiovascular events in hypertensive patients.
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Affiliation(s)
- Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine
| | - Hyung Jun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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36
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Park MS, Jeon J, Song TJ, Kim J. Association of periodontitis with microvascular complications of diabetes mellitus: A nationwide cohort study. J Diabetes Complications 2022; 36:108107. [PMID: 35063344 DOI: 10.1016/j.jdiacomp.2021.108107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Periodontitis is a common chronic inflammatory disease and one of oral complications in diabetes. Diabetes-related microvascular complications and periodontitis are also closely related to systemic inflammation. We hypothesized that periodontitis and oral hygiene markers might increase the risk of microvascular complications in diabetes mellitus. METHODS We enrolled 11,353 diabetes participants without prior microvascular complications who received complete oral health checkups in the National Health Insurance Service-National Health Screening Cohort in 2003-2004. The primary outcome was the first development of diabetes-related microvascular complications, including nephropathy, neuropathy, and retinopathy. RESULTS The age of all participants was 55.27 ± 9.46 years, and 7833 (68.99%) participants were male. Periodontitis was noted in 8.37%. During the 7.03 ± 4.30 year of the mean follow-up period, 7227 patients experienced diabetes-related microvascular complications (2645 with nephropathy, 2513 with neuropathy, 2069 with retinopathy). Multivariable Cox regression analyses revealed that periodontitis was an independent risk factor for diabetes-related microvascular complications (adjusted hazard ratio (HR):1.13; 95% confidence interval (CI):1.04-1.23; p = 0.004). In the secondary analysis for individual microvascular complications, periodontitis was an independent risk factor for retinopathy (adjusted HR: 1.21; 95% CI: 1.04-1.40; p = 0.013). CONCLUSIONS The presence of periodontitis was associated with an increased risk of microvascular complications in diabetes patients.
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Affiliation(s)
- Moo-Seok Park
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Chen GQ, Duan Y, Wang JF, Lian Y, Yin XL. Serum α-Klotho associated with oral health among a nationally representative sample of US adults. Front Endocrinol (Lausanne) 2022; 13:970575. [PMID: 36204099 PMCID: PMC9530453 DOI: 10.3389/fendo.2022.970575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Low klotho is associated with aging-related traits. However, no study has assessed the association between klotho and oral health in a large sample of population. This study aimed to explore the association between serum α-klotho and oral health in US Adults. METHODS Data were from the National Health and Nutrition Examination Survey. Oral health parameters included periodontitis, self-rated oral health, and tooth loss. Logistic regression and restricted cubic spline models were adopted to evaluate the associations. RESULTS A total of 6187 participants were included in the study. The median of the α-klotho level was 815.2 pg/mL. Serum α-Klotho was significantly lower in participants with poor oral health (all P <0.01). Compared with the highest tertile, the lowest tertile of α-klotho was associated with moderate/severe periodontitis, poor-rated oral health, and tooth loss, with OR (95% CI) being 1.21 (1.01, 1.48), 1.26 (1.01, 1.56) and 1.38 (1.05, 1.84), respectively. An increment of per 1 standard deviation in the α-klotho concentration was associated with lower odds of moderate/severe periodontitis (OR: 0.93; 95% CI: 0.87, 0.99). Linear dose-response relationships were found between α-klotho and the odds of moderate/severe periodontitis (P for non-linearity=0.88) and poor-rated oral health (P for non-linearity=0.66). An L-shaped dose-response relationship was found between levels of α-klotho and the odds of tooth loss (P for non-linearity=0.04). CONCLUSIONS Serum α-klotho was associated with oral health. Further studies are necessary to clarify the potential mechanisms and demonstrate the predictive ability of klotho in oral diseases.
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Affiliation(s)
- Guo-Qiang Chen
- Department of Health Management & Engineering Laboratory for Health Management, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital & The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yao Duan
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital & The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Jin-Feng Wang
- Department of Nursing, Center for Mental Health of Jinan City, Jinan, China
| | - Ying Lian
- Department of Medical Record Management and Statistics, Shandong Provincial Qianfoshan Hospital & The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Xiu-Li Yin
- Department of Gastroenterology, Shandong Rongjun General Hospital, Jinan, China
- *Correspondence: Xiu-Li Yin,
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Yamanaka F, Tsujita K, Saito S. Periodontal Disease as a Potential Risk Factor of Cardiovascular Disease. Circ J 2021; 86:819-820. [PMID: 34955482 DOI: 10.1253/circj.cj-21-1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital.,Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Shigeru Saito
- Department of Cardiology, Shonan Kamakura General Hospital
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Saijo Y, Okada H, Hamaguchi M, Okamura T, Hashimoto Y, Majima S, Sennmaru T, Nakanishi N, Ushigome E, Asano M, Yamazaki M, Fukui M. Association between the frequency of toothbrushing and lifestyle in people with type 2 diabetes mellitus: at the baseline date of the Kamogawa-DM cohort study. J Clin Biochem Nutr 2021; 69:294-298. [PMID: 34857992 PMCID: PMC8611365 DOI: 10.3164/jcbn.21-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022] Open
Abstract
It has been reported that oral health is associated with some co-morbid conditions, including cardiovascular disease, in people with type 2 diabetes mellitus. The present study investigated the association between the frequency of toothbrushing and lifestyle in people with type 2 diabetes mellitus. This cross-sectional study included 624 outpatients at the Kyoto Prefectural University of Medicine in Kyoto, Japan from January 2014 to January 2016. Lifestyle was evaluated using a self-administered questionnaire. The average age and hemoglobin A1c level were 67.6 ± 10.9 years and 7.2 ± 1.1%, respectively. The number of patients who brushed their teeth twice or more a day was 189 (50.3%) in men and 198 (79.8%) in women. Among men, the proportion of patients living alone was lower in those who brushed their teeth twice or more a day than those who brushed their teeth never/rarely or once a day. The logistic regression analysis, after adjusting for confounding factors, revealed that living alone (odds ratio 2.88; 95% confidence interval 1.53–5.66) was associated with the increased odds of the low frequency of toothbrushing (never/rarely or once a day) in men, but not in women. In conclusion, the results of our study suggest that living alone was associated with the low frequency of toothbrushing in people with type 2 diabetes mellitus, particularly in men.
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Affiliation(s)
- Yuto Saijo
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Hiroshi Okada
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Saori Majima
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takafumi Sennmaru
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Zhuang Z, Gao M, Lv J, Yu C, Guo Y, Bian Z, Yang L, Du H, Chen Y, Ning F, Liu H, Chen J, Chen Z, Huang T, Li L. Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults. Eur J Clin Invest 2021; 51:e13634. [PMID: 34152010 DOI: 10.1111/eci.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.
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Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Meng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Feng Ning
- NCDs Prevention and Control Department, Qingdao CDC, Qingdao, China
| | - Huilin Liu
- NCDs Prevention and Control Department, Hunan CDC, Hunan, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
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Chang Y, Lee JS, Woo HG, Ryu DR, Kim JW, Song TJ. Improved oral hygiene care and chronic kidney disease occurrence: A nationwide population-based retrospective cohort study. Medicine (Baltimore) 2021; 100:e27845. [PMID: 34964752 PMCID: PMC8615368 DOI: 10.1097/md.0000000000027845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/11/2021] [Indexed: 01/05/2023] Open
Abstract
Oral diseases or poor oral hygiene have close connections with systemic inflammatory reaction, which is one of major mechanism in the development of chronic kidney disease (CKD). We conducted a research assuming that better oral hygiene care would be negatively related with the risk of developing new-onset CKD.From 2003 to 2004, a total of 158,495 participants from the Korean national health insurance data sharing service which provides health screening data including variables as age, sex, vascular risk factors, medication information, indicators regarding oral hygiene, and laboratory results. The diagnosis of CKD and vascular risk factors were defined according to the International Statistical Classification of Diseases and Related Health Problems codes-10th revision. The follow-up period for the study subject was until the occurrence of CKD, until death, or Dec 31, 2015.Approximately 13.3% of the participants suffered from periodontal disease, and 40.7% brushed their teeth at least three times a day. With a median of 11.6 (interquartile range 11.3-12.2) years' follow-up, the cohort included 3223 cases of incident CKD. The 10-year incidence rate for CKD was 1.80%. In multivariable analysis with adjustment for age, sex, demographics, vascular risk factors, blood pressure, and blood laboratory results, frequent tooth brushing (≥3 times a day) was negatively related to occurrence of CKD (hazard ratio: 0.90, 95% confidence interval [0.83-0.99], P = .043, P value for trend = .043).Participants with improved oral hygiene (≥3 times a day) have showed less risk of CKD. Additional interventional studies are in need to establish causative relationship between oral hygiene and risk of CKD.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
| | - Ho Geol Woo
- Department of Neurology, Kyung Hee University Hospital and College of Medicine, Seoul, Korea
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
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Struppek J, Schnabel RB, Walther C, Heydecke G, Seedorf U, Lamprecht R, Smeets R, Borof K, Zeller T, Beikler T, Börschel CS, Karakas M, Gosau M, Aarabi G. Periodontitis, dental plaque, and atrial fibrillation in the Hamburg City Health Study. PLoS One 2021; 16:e0259652. [PMID: 34807935 PMCID: PMC8608306 DOI: 10.1371/journal.pone.0259652] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023] Open
Abstract
Background/Aim Atrial fibrillation (AF) is a major health problem and causes heart failure and stroke. Pathophysiological mechanisms indicate a link with oral health including periodontitis (PD), but supporting data are scarce. The aim was to investigate the link between features of oral health and the prevalence of AF. Methods This cross-sectional analysis of the Hamburg City Health Study included 5,634 participants with complete data on their PD and AF status. AF was assessed via self-reported questionnaire or medically diagnosed by standard 12-lead resting ECG. The oral health examination included full-mouth measurements of the dental plaque index (PI), the clinical attachment loss (CAL) at 6 sites per tooth, the bleeding on probing (BOP) and the decayed, missing and filled teeth (DMFT) index. Descriptive analyses for all variables stratified by the status of PD were performed. To test for an association between prevalent PD and prevalent AF, multivariable logistic regression models were used. Mediation analysis was used to test if interleukin-6 (IL-6) and/or C-reactive protein (CRP) mediated the association between PD and AF. Results Atrial fibrillation (prevalence: 5.6%) and the severity of PD (prevalence: moderate: 57.7%, severe: 18.9%) increased with age in men and women. Prevalent severe PD, CAL ≥3 mm, PI, and BOP were all associated with prevalent AF in unadjusted regression analysis. However, no association except for PI (odds ratio (OR): 1.22, 95% confidence interval (CI): 1.1–1.35, p<0.001) could be observed after adjusting for age, sex, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), body mass index, diabetes, smoking, and educational level. Participants brushing their teeth at least twice daily had a lower AF prevalence compared with those brushing only once daily. Hs-CRP, IL-6, and the odds of AF increased as a function of PD severity grades in unadjusted analysis. However, neither the DMFT index nor IL-6 or CRP was associated with AF after adjusting for age and sex. Mediation analyses could not provide support for the hypothesis that IL-6 or CRP acted as mediator of the association between prevalent PD and prevalent AF. Conclusion The study shows an association between prevalent AF and increased dental plaque levels indicated by a higher PI. In contrast, an association of prevalent PD with prevalent AF after adjustments for several confounders could not be demonstrated. Further studies are necessary to investigate the mechanisms underlying poor oral hygiene and AF as well as the influence of improved oral hygiene on AF onset.
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Affiliation(s)
- Julia Struppek
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Renate B. Schnabel
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK e.V.) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
| | - Carolin Walther
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ragna Lamprecht
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Division of “Regenerative Orofacial Medicine”, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK e.V.) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christin S. Börschel
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK e.V.) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
| | - Mahir Karakas
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK e.V.) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
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Kim HJ, Park MS, Shin JI, Park J, Kim DH, Jeon J, Kim J, Song TJ. Associations of heart failure with susceptibility and severe complications of COVID-19: A nationwide cohort study. J Med Virol 2021; 94:1138-1145. [PMID: 34738248 PMCID: PMC8661586 DOI: 10.1002/jmv.27435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/19/2021] [Accepted: 11/02/2021] [Indexed: 12/23/2022]
Abstract
Infection is associated with occurrence and worsening of heart failure (HF). However, studies on the association of susceptibility and severe complications of coronavirus disease 2019 (COVID-19) with HF history are limited. From the Korean nationwide COVID-19 data set, 212,678 participants with at least one severe acute respiratory syndrome coronavirus 2 real-time reverse transcription polymerase chain reaction (RT-PCR) test were included between January 1 and June 4, 2020. To investigate the association of HF with susceptibility and severe complications of COVID-19, 1:4 ratio propensity score matching (PSM) and logistic regression analysis were performed. The primary outcome was a composite outcome of mechanical ventilation, intensive care unit (ICU) admission, and death. After PSM, COVID-19 PCR positivity did not show a significant difference according to HF history in multivariable analysis (odds ratio [OR]: 0.91, 95% confidence interval (CI) (0.79-1.04), p = 0.146). Of 7630 individuals with confirmed COVID-19 infection, 310 (4.1%) had HF history. The overall primary outcome occurred in 426 (5.6%) individuals, including 159 (2.1%) cases of mechanical ventilation, 254 (3.3%) cases of ICU admission, and 215 (2.8%) cases of death. In multivariate logistic analysis, presence of HF history was associated independently with primary outcome (OR: 1.99, 95% CI: 1.42-2.79, p < 0.001), particularly mortality (OR: 2.02, 95% CI: 1.36-3.00, p < 0.001). Our study demonstrated that HF history is associated poor prognosis, particularly mortality, in COVID-19. Patients with HF can have severe complication if infected with COVID-19; therefore, careful management are necessary.
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Affiliation(s)
- Hyung Jun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Moo-Suk Park
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Park
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Dong-Hyeok Kim
- Department of Cardiology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Republic of Korea
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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44
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Pinto RD, Monaco A, Ortu E, Czesnikiewicz-Guzik M, Aguilera EM, Giannoni M, D'Aiuto F, Guzik TJ, Ferri C, Pietropaoli D. Access to dental care and blood pressure profiles in adults with high socioeconomic status. J Periodontol 2021; 93:1060-1071. [PMID: 34726790 PMCID: PMC9542004 DOI: 10.1002/jper.21-0439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/14/2021] [Accepted: 10/17/2021] [Indexed: 11/18/2022]
Abstract
Background Reduced access to dental care may increase cardiovascular risk; however, socioeconomic factors are believed to confound the associations. We hypothesized that the relation persists despite economic wellness and high education, with reduced access to dental care affecting cardiovascular risk at least in part through its effect on blood pressure (BP), possibly mediated by systemic inflammation. Methods We first assessed the sociodemographic and clinical characteristics related to last dental visit timing (≤ or >6 months; self‐reported) using national representative cross‐sectional data. Then, the association of last dental visit timing with clinic BP was selectively investigated in highly educated, high income participants, further matched for residual demographic and clinical confounders using propensity score matching (PSM). The mediating effect of systemic inflammation was formally tested. Machine learning was implemented to investigate the added value of dental visits in predicting high BP over the variables included in the Framingham Hypertension Risk Score among individuals without an established diagnosis of hypertension. Results Of 27,725 participants included in the population analysis, 46% attended a dental visit ≤6 months. In the PSM cohort (n = 2350), last dental visit attendance >6 months was consistently associated with 2 mmHg higher systolic BP (P = 0.001) and with 23 to 35% higher odds of high/uncontrolled BP compared with attendance ≤6 months. Inflammation mildly mediated the association. Access to dental care improved the prediction of high BP by 2%. Conclusions Dental care use impacts on BP profiles independent of socioeconomic confounders, possibly through systemic inflammation. Regular dental visits may contribute to preventive medicine.
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Affiliation(s)
- Rita Del Pinto
- Unit of Internal Medicine and Nephrology - Center for Hypertension and Cardiovascular Prevention - San Salvatore Hospital - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy.,Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Annalisa Monaco
- Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.,Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Dental Clinic - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy
| | - Eleonora Ortu
- Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.,Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Dental Clinic - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy
| | - Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow, UK.,Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Eva Muñoz Aguilera
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Mario Giannoni
- Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.,Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Dental Clinic - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Department of Internal and Agricultural Medicine, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Claudio Ferri
- Unit of Internal Medicine and Nephrology - Center for Hypertension and Cardiovascular Prevention - San Salvatore Hospital - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy.,Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Davide Pietropaoli
- Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.,Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Dental Clinic - University of L'Aquila, Department of Life, Health and Environmental Sciences, L'Aquila, Italy
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Wee CW, Lee HJ, Lee JR, Lee H, Kwoen MJ, Jeong WJ, Eom KY. Effect of National Oral Health Screening Program on the Risk of Head and Neck Cancer: A Korean National Population-Based. Cancer Res Treat 2021; 54:709-718. [PMID: 34696565 PMCID: PMC9296931 DOI: 10.4143/crt.2021.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC. Materials and Methods Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+. Results A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877). Conclusion The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.
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Affiliation(s)
- Chan Woo Wee
- Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyo-Jung Lee
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Jeong Kwoen
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keun-Yong Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
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46
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Association between Findings in Oral Health Screening and Body Mass Index: A Nation-Wide Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111062. [PMID: 34769582 PMCID: PMC8582665 DOI: 10.3390/ijerph182111062] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/15/2021] [Indexed: 12/20/2022]
Abstract
Oral diseases, such as periodontitis and dental caries, can cause systemic inflammation as well as local effects, which is an important contributing factor for obesity. We aimed to investigate the change in body mass index (BMI) according to the presence of periodontitis and oral hygiene indicators. This study enrolled 110,068 participants from the national health screening cohort in Korea from 2009–2010 who underwent an oral health checkup. As oral hygiene indicators, the presence of periodontitis, dental caries, tooth loss, and tooth brushing were assessed. We constructed a linear mixed model for BMI. BMI was repeatedly measured in the health examination until 2015. In the multivariate linear mixed model for BMI, the presence of periodontitis (β = 0.0687, standard error (SE) = 0.0225, p = 0.002), dental caries (β = 0.0735, SE = 0.0152, p < 0.001), and tooth loss (β = 0.1328, SE = 0.0175, p < 0.001) were positively associated with BMI. In contrast, frequent tooth brushing (≥3 times/day) was negatively associated with BMI (β = −0.2610, SE = 0.0306, p < 0.001). The presence of periodontitis, dental caries, and tooth loss may be associated with higher BMI, whereas frequent tooth brushing may be related to lower BMI. Better oral hygiene might be associated with lower BMI. Further study is needed to determine the effect of oral health behavior and dental disease on obesity.
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Leopold KT, Kim SY, Narang B, Mirpuri S, Meraji NN, Roberts N, Li Y, Gany F. Predictors of Limited Access to Dental Health Care Among NYC Taxi/FHV Drivers. J Community Health 2021; 46:869-875. [PMID: 33523409 PMCID: PMC9204610 DOI: 10.1007/s10900-020-00955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 12/01/2022]
Abstract
Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016-2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28-0.89; p < .05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60-4.63; p < .001) or lack of primary care provider (2.72 OR; 95% CI, 1.60-4.63; p < .001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p = .026) and no past-year dental cleaning (p < .001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p = .028) and lack of past-year dental cleaning (p = .014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk.
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Affiliation(s)
- Katherine T Leopold
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Sheena Mirpuri
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Nujbat Nasim Meraji
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Nicole Roberts
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Yuelin Li
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA.
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA.
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Association of Periodontal Disease with the Occurrence of Unruptured Cerebral Aneurysm among Adults in Korea: A Nationwide Population-Based Cohort Study TRANSLATE with x EnglishArabicHebrewPolishBulgarianHindiPortugueseCatalanHmong DawRomanianChinese SimplifiedHungarianRussianChinese TraditionalIndonesianSlovakCzechItalianSlovenianDanishJapaneseSpanishDutchKlingonSwedishEnglishKoreanThaiEstonianLatvianTurkishFinnishLithuanianUkrainianFrenchMalayUrduGermanMalteseVietnameseGreekNorwegianWelshHaitian CreolePersian// TRANSLATE with COPY THE URL BELOW Back EMBED THE SNIPPET BELOW IN YOUR SITE Enable collaborative features and customize widget: Bing Webmaster PortalBack//. MEDICINA-LITHUANIA 2021; 57:medicina57090910. [PMID: 34577833 PMCID: PMC8465273 DOI: 10.3390/medicina57090910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Cerebral aneurysms can cause disability or death during rupture, but information on the etiology of cerebral aneurysms is currently lacking. Periodontal disease causes both systemic inflammation and local inflammation of the oral cavity. Systemic inflammation is a major cause of cerebral aneurysms. The aim of our study was to determine whether the presence of periodontal disease is related to the occurrence of unruptured cerebral aneurysms in a nationwide population-based cohort. Materials and Methods: We analyzed data on demographics, previous medical history, and laboratory test results of 209,620 participants from the Korean National Health Insurance System-Health Screening Cohort. The presence of periodontal disease and oral hygiene parameters, including the number of lost teeth, tooth brushing frequency per day, dental visits for any reason, and expert teeth scaling, were investigated. The occurrences of unruptured cerebral aneurysms (I67.1) were defined according to the International Statistical Classification of Diseases Related Health Problems-10. Results: The mean age of the participants was 53.7 ± 8.7 years, and 59.4% were male. Periodontal disease was found in 20.9% of the participants. A total of 2160 (1.0%) cases of unruptured cerebral aneurysms developed after 10.3 years of median follow up. In multivariate analysis, the presence of periodontal disease was significantly associated with an increased risk of unruptured cerebral aneurysms (hazard ratio: 1.21, 95% confidence interval: 1.09–1.34, p < 0.001). Conclusion: The presence of periodontal disease could be associated with the occurrence of unruptured cerebral aneurysms. It should be noted that when periodontal diseases are present, the risk of aneurysms is increased in the future.
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Lăzureanu PC, Popescu F, Tudor A, Stef L, Negru AG, Mihăilă R. Saliva pH and Flow Rate in Patients with Periodontal Disease and Associated Cardiovascular Disease. Med Sci Monit 2021; 27:e931362. [PMID: 34305133 PMCID: PMC8323473 DOI: 10.12659/msm.931362] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/15/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Periodontal disease, a frequent oral health problem, is connected with cardiovascular morbidity and mortality. This study aimed to assess the unstimulated saliva flow rate and saliva pH as markers of the severity of periodontal disease in patients with cardiovascular disease. MATERIAL AND METHODS A cohort of 155 patients (78 men and 77 women, aged 30-92 years) was included, and a structured questionnaire obtained information about their health status, oral healthcare behaviors, and eating habits. An oral examination was performed to assess periodontal status and presence of dental calculus. The unstimulated whole salivary flow rate and salivary pH were measured. An oral hygienization was performed, and 3 months later, salivary flow rate and pH were reevaluated. RESULTS A severe form of periodontal disease was found in 22.4% of patients. Disease severity was strongly correlated with low pH values (6.25 in stage IV periodontal disease), lower salivary flow rate (0.28 mL/min), smoking, poor oral hygiene habits and obesity, with no significant differences by sex. We observed a significant increase of pH (up to 6.30±0.17) in patients with severe periodontal disease (P=0.001) and salivary flow rate values (0.29±0.07 mL/min; P=0.014) 3 months after oral hygienization. There was a strong association between the severity of periodontal disease and presence of cardiovascular disease (P=0.001). CONCLUSIONS Our study suggests that the decrease of salivary flow rate and pH level might be associated with the severity of periodontal disease.
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Affiliation(s)
| | - Florina Popescu
- Department of Occupational Health, Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Anca Tudor
- Department of Functional Science, Discipline of Medical Informatics and Biostatistics Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Laura Stef
- Department of Oral Health and Nursing, Faculty of Medicine, Research Center for Complex Physical Systems, Lucian Blaga University, Sibiu, Romania
| | - Alina Gabriela Negru
- Department of Cardiology, Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Romeo Mihăilă
- Department of Internal Medicine, County Emergency Hospital Sibiu, Faculty of Medicine, Lucian Blaga University, Sibiu, Romania
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Hassan AO, Lip GYH, Bisson A, Herbert J, Bodin A, Fauchier L, Harris RV. Acute Dental Periapical Abscess and New-Onset Atrial Fibrillation: A Nationwide, Population-Based Cohort Study. J Clin Med 2021; 10:jcm10132927. [PMID: 34208797 PMCID: PMC8269096 DOI: 10.3390/jcm10132927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/24/2022] Open
Abstract
There are limited data on the relationship of acute dental infections with hospitalisation and new-onset atrial fibrillation (AF). This study aimed to assess the relationship between acute periapical abscess and incident AF. This was a retrospective cohort study from a French national database of patients hospitalized in 2013 (3.4 million patients) with at least five years of follow up. In total, 3,056,291 adults (55.1% female) required hospital admission in French hospitals in 2013 while not having a history of AF. Of 4693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess that developed AF over a mean follow-up of 4.8 ± 1.7 years. Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). The CHA2DS2VASc score in patients with acute dental periapical abscess had moderate predictive value for development of AF, with Area Under the Curve (AUC) 0.73 (95% CI, 0.71–0.76). An increased risk of new onset AF was identified for individuals hospitalized with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections is needed for incident AF, as well as investigations of possible mechanisms linking these conditions.
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Affiliation(s)
- Amaar Obaid Hassan
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK; (A.O.H.); (R.V.H.)
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L69 7TX, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- Correspondence: ; Tel.: +44-151-794-9020
| | - Arnaud Bisson
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau Faculté de Médecine, Université François Rabelais, 37044 Tours, France; (A.B.); (J.H.); (A.B.); (L.F.)
| | - Julien Herbert
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau Faculté de Médecine, Université François Rabelais, 37044 Tours, France; (A.B.); (J.H.); (A.B.); (L.F.)
| | - Alexandre Bodin
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau Faculté de Médecine, Université François Rabelais, 37044 Tours, France; (A.B.); (J.H.); (A.B.); (L.F.)
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau Faculté de Médecine, Université François Rabelais, 37044 Tours, France; (A.B.); (J.H.); (A.B.); (L.F.)
| | - Rebecca V. Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK; (A.O.H.); (R.V.H.)
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