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Lee SY. Association between gingivitis, tooth loss and cardiovascular risk: Insights from a 10-year nationwide cohort study of 3.7 million Koreans. PLoS One 2024; 19:e0308250. [PMID: 39093905 PMCID: PMC11296644 DOI: 10.1371/journal.pone.0308250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 07/20/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND While studies have suggested an association between periodontal disease and an increased risk of cardiovascular disease, the strength of this association and its specific links to various types of cardiovascular disease have not been thoroughly investigated. This study aimed to examine how gingivitis and tooth loss affect cardiovascular diseases, probing their individual impacts. METHODS A retrospective cohort study was conducted, encompassing 3,779,490 individuals with no history of cardiovascular disease, utilizing data from the National Health Examination and the Korean National Health Insurance database from 2006 to 2019. Cox proportional hazards models were applied to estimate the association between tooth loss, gingivitis, and cardiovascular disease. RESULTS Following a median follow-up of 10.38 years, 17,942 new cardiovascular disease cases were identified, comprising 10,224 cases of angina pectoris, 6,182 cases of acute myocardial infarction, and 9,536 cases of stroke. It was observed that the risk of stroke was significantly higher in the tooth loss group compared to the control group (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.04-1.15). In the group with gingivitis and tooth loss, the risk of stroke and cardiovascular disease was significantly higher than in the control group (aHR: 1.12, 95% CI: 1.04-1.20; aHR: 1.08, 95% CI: 1.03-1.14). The gingivitis group exhibited a higher risk associated with stroke (aHR: 1.05, 95% CI: 1.01-1.10) among individuals aged 50 and above. However, statistically significant associations between periodontal disease and angina pectoris were not observed, nor between periodontal disease and acute myocardial infarction except among those aged above 50. Furthermore, the association between periodontal disease and cardiovascular disease was found to be stronger among individuals over the age of 50, males, those with obesity, and smokers compared to the control group. CONCLUSIONS Our results emphasize the association of tooth loss and gingivitis with cardiovascular disease, specifically stroke, underlining the critical need for preventive oral healthcare. Tailored interventions are necessary to reduce the heightened risk of cardiovascular disease events, especially stroke, among older, obese individuals and smokers.
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Affiliation(s)
- Seung Yeon Lee
- Seoul National University Hospital, Seoul, Republic of Korea
- Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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2
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Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, Masuda D, Miyamatsu N, Nishio Y, Ogura M, Sata M, Sekiguchi K, Takeya Y, Tamura K, Wakatsuki A, Yoshida H, Fujioka Y, Fukazawa R, Hamada O, Higashiyama A, Kabayama M, Kanaoka K, Kawaguchi K, Kosaka S, Kunimura A, Miyazaki A, Nii M, Sawano M, Terauchi M, Yagi S, Akasaka T, Minamino T, Miura K, Node K. JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease. Circ J 2024; 88:763-842. [PMID: 38479862 DOI: 10.1253/circj.cj-23-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Wayo Women's University
| | - Hisashi Kai
- Department of Cardiology, Kurume Univeristy Medical Center
| | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Masatsune Ogura
- Department of General Medical Science, Chiba University School of Medicine
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Yasushi Takeya
- Division of Helath Science, Osaka University Gradiate School of Medicine
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | | | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University
| | | | - Osamu Hamada
- Department of General Internal Medicine, Takatsuki General Hospital
| | | | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Kenjiro Kawaguchi
- Division of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
| | | | | | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine
- Yale New Haven Hospital Center for Outcomes Research and Evaluation
| | | | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Cerebral Center
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Meidicine
| | - Katsuyuki Miura
- Department of Preventive Medicine, NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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3
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Leng Y, Hu Q, Ling Q, Yao X, Liu M, Chen J, Yan Z, Dai Q. Periodontal disease is associated with the risk of cardiovascular disease independent of sex: A meta-analysis. Front Cardiovasc Med 2023; 10:1114927. [PMID: 36923959 PMCID: PMC10010192 DOI: 10.3389/fcvm.2023.1114927] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Objectives Studies have established a link between periodontal disease and cardiovascular disease (CVD), but it is unclear whether there is a sex difference in their association. Methods The PubMed, Embase, and Cochrane databases were searched until June, 21 2022. Cardiovascular outcomes included any CVD, myocardial infarction (MI), coronary heart disease (CHD), or stroke. Studies reported the prevalence of CVD in patients with periodontal disease and the relationship between periodontal disease and CVD. The study is registered with PROSPERO (CRD42022333663). The level of evidence and recommendations is assessed by the Grading of Recommendations for Assessment, Development and Evaluation (GRADE). Results Twenty-six studies were included. In patients with periodontal disease, the prevalence of CVD was 7.2% [9 studies; 95% confidence interval (CI): 2.7-13.6%], and prevalence for CHD, hypertension, stroke, and heart failure was 6.6, 25.3, 1, and 1.1%, respectively. There was a significant association between periodontal disease and CVD in men [odds ratio (OR) = 1.22; 95% CI: 1.12-1.34] and women (OR = 1.11; 95% CI: 1.05-1.17), with no significant sex difference (P > 0.05). Conclusion Cardiovascular disease is relatively common in patients with periodontal disease, and an increased risk of CVD is associated with periodontal disease independent of sex. Interventions targeting periodontal disease may be beneficial for CVD. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022333663.
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Affiliation(s)
- Yurong Leng
- The Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, Jiangxi, China
| | - Qinwen Hu
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Qin Ling
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Xiongda Yao
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Menglu Liu
- Department of Cardiology, Seventh People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Jiawei Chen
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
| | - Qun Dai
- The Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, Jiangxi, China
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4
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Nakayama Y, Tabe S, Yamaguchi A, Tsuruya Y, Kobayashi R, Oyama K, Kitano D, Kojima K, Kogawa R, Okumura Y, Ogihara J, Senpuku H, Ogata Y. Identification of Nutritional Factors to Evaluate Periodontal Clinical Parameters in Patients with Systemic Diseases. Nutrients 2023; 15:nu15020365. [PMID: 36678235 PMCID: PMC9866370 DOI: 10.3390/nu15020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Nutritional factors reflect the periodontal parameters accompanying periodontal status. In this study, the associations between nutritional factors, blood biochemical items, and clinical parameters were examined in patients with systemic diseases. The study participants were 94 patients with heart disease, dyslipidemia, kidney disease, or diabetes mellitus. Weak negative correlation coefficients were found between nine clinical parameters and ten nutritional factors. Stage, grade, mean probing depth (PD), rate of PD 4−5 mm, rate of PD ≥ 6 mm, mean clinical attachment level (CAL), and the bleeding on probing (BOP) rate were weakly correlated with various nutritional factors. The clinical parameters with coefficients of determinations (R2) > 0.1 were grade, number of teeth, PD, rate of PD 4−5 mm, CAL, and BOP rate. PD was explained by yogurt and cabbage with statistically significant standardized partial regression coefficients (yogurt: −0.2143; cabbage and napa cabbage: −0.2724). The mean CAL was explained by pork, beef, mutton, and dark green vegetables with statistically significant standardized partial regression coefficients (−0.2237 for pork, beef, and mutton; −0.2667 for dark green vegetables). These results raise the possibility that the frequency of intake of various vegetables can be used to evaluate periodontal stabilization in patients with systemic diseases.
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Affiliation(s)
- Yohei Nakayama
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence: ; Tel.: +81-47-360-9363; Fax: +81-47-360-9364
| | - Shinichi Tabe
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Arisa Yamaguchi
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Yuto Tsuruya
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Ryoki Kobayashi
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Department of Microbiology and Immunology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Katsunori Oyama
- Department of Computer Science, College of Engineering, Nihon University, Fukushima 963-8642, Japan
| | - Daisuke Kitano
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Keisuke Kojima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Rikitake Kogawa
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Jun Ogihara
- Laboratory of Applied Microbiology and Biotechnology, College of Bioresource Sciences, Nihon University, Fujisawa-shi 252-0880, Japan
| | - Hidenobu Senpuku
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Department of Microbiology and Immunology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
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5
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Yamada S, Komiyama T, Ohi T, Murakami T, Miyoshi Y, Endo K, Hiratsuka T, Hara A, Satoh M, Tatsumi Y, Inoue R, Asayama K, Kikuya M, Hozawa A, Metoki H, Imai Y, Ohkubo T, Hattori Y. Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study. J Periodontal Res 2022; 57:615-622. [PMID: 35388479 PMCID: PMC9321748 DOI: 10.1111/jre.12990] [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: 12/03/2021] [Revised: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
Objective We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan. Background Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan. Methods The participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque. Results Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively. Conclusion The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.
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Affiliation(s)
- Sho Yamada
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Takahisa Murakami
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takako Hiratsuka
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Azusa Hara
- Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital, Sendai, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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6
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Maruoka Y, Michiwaki Y, Sekiya H, Kurasawa Y, Natsume N. What does oral care mean to society? Biosci Trends 2022; 16:7-19. [DOI: 10.5582/bst.2022.01046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Yutaka Maruoka
- Oral and Maxillofacial Surgery, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihiro Michiwaki
- Division of Special Dentistry and Oral Surgery, Japanese Red Cross Musashino Hospital, Musashino, Japan
| | - Hideki Sekiya
- Department of Oral Surgery, School of Medicine, Toho University, Tokyo, Japan
| | - Yasuhiro Kurasawa
- Oral and Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nagato Natsume
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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7
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Miki K, Kitamura M, Hatta K, Kamide K, Gondo Y, Yamashita M, Takedachi M, Nozaki T, Fujihara C, Kashiwagi Y, Iwayama T, Takahashi T, Sato H, Murotani Y, Kabayama M, Takeya Y, Takami Y, Akasaka H, Yamamoto K, Sugimoto K, Ishizaki T, Masui Y, Rakugi H, Ikebe K, Murakami S. Periodontal inflamed surface area is associated with hs-CRP in septuagenarian Japanese adults in cross-sectional findings from the SONIC study. Sci Rep 2021; 11:14436. [PMID: 34262126 PMCID: PMC8280099 DOI: 10.1038/s41598-021-93872-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/01/2021] [Indexed: 12/30/2022] Open
Abstract
Periodontal disease is a chronic inflammatory condition that affects various peripheral organs. The periodontal inflamed surface area (PISA) quantifies periodontitis severity and the spread of inflammatory wounds. This study aimed to investigate the association between PISA and high-sensitivity C-reactive protein (hs-CRP), a systemic inflammation marker. This study included 250 community-dwelling septuagenarians (69-71 years). We collected information on their medical (e.g., diabetes and dyslipidemia) and dental examinations (e.g., measurement of the probing pocket depth). Generalized linear model analysis was used to explore the association between PISA and hs-CRP levels. There was a significant difference in hs-CRP levels between groups with PISA ≥ 500 and < 500 (p = 0.017). Moreover, the generalized linear model analysis revealed a significant association between PISA and hs-CRP levels (risk ratio = 1.77; p = 0.033) even after adjusting other factors. Further, we found a correlation between PISA and hs-CRP (Spearman's rank correlation coefficient, rs = 0.181; p = 0.023). Our findings suggest that PISA is an effective index for estimating the effect of periodontitis on the whole body, enabling medical-dental cooperation.
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Affiliation(s)
- Koji Miki
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masahiro Kitamura
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kodai Hatta
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kei Kamide
- Division of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Science, Suita, Osaka, Japan
| | - Motozo Yamashita
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masahide Takedachi
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takenori Nozaki
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
- Division for Interdisciplinary Dentistry, Osaka University Dental Hospital, Suita, Osaka, Japan
| | - Chiharu Fujihara
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoichiro Kashiwagi
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomoaki Iwayama
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hitomi Sato
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Yuki Murotani
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Mai Kabayama
- Division of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasushi Takeya
- Division of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ken Sugimoto
- Department of General and Geriatric Medicine, Kawasaki Medical University, Okayama, Okayama, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Shinya Murakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan
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8
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Saka-Herrán C, Jané-Salas E, González-Navarro B, Estrugo-Devesa A, López-López J. Validity of a self-reported questionnaire for periodontitis in a Spanish population. J Periodontol 2020; 91:1027-1038. [PMID: 31984491 DOI: 10.1002/jper.19-0604] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/28/2019] [Accepted: 12/29/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Clinical examination is the gold-standard approach for surveillance of periodontitis; however, it requires large resources. Several self-reported measures have been developed and tested in diverse scenarios with results suggesting that it may be a useful tool for screening periodontal disease in different populations; yet they have not being tested in Spanish population. We aimed to assess the validity of a self-reported questionnaire for periodontitis in a Spanish population from Barcelona during 2018. METHODS One hundred and twelve participants were enrolled in the study and, in one appointment; a dentist performed the self-reported questionnaire and a full-mouth periodontal examination. Periodontitis was defined as at least mild periodontitis according to three criterion of classification. Receiver-operating characteristics curve analyses were used to test the discriminatory capability, sensitivity and specificity of the self-reported questionnaire and logistic regression models were adjusted to estimate the minimal-set of questions associated with periodontitis. RESULTS The self-reported questionnaire had a useful discriminative capability for detecting individuals with periodontitis (area under the curve [AUC] = 0.85 95% CI 0.78-0.92) and its moderate/severe form (AUC = 0.86 95% CI 0.79-0.04) with sensitivity and specificity of 77% and 74% and 73% and 87%, respectively; representing moderate validity. The combination of four-specific questions had high accuracy (AUC = 0.88 95% CI 0.81-0.94) and validity (sensitivity = 92.2%) and was strongly associated with moderate/severe periodontitis after adjusting by socio-demographic factors. CONCLUSIONS The use of several self-reported questions proved to have a good performance for screening periodontitis in the population under study; specifically, those related with tooth mobility and gum migration. Large community-based studies are needed to test its validity and predictive capability.
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Affiliation(s)
- Constanza Saka-Herrán
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Beatriz González-Navarro
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Odontological Hospital University of Barcelona, University of Barcelona Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
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Microbiome composition comparison in oral and atherosclerotic plaque from patients with and without periodontitis. Odontology 2020; 109:239-249. [PMID: 32430725 DOI: 10.1007/s10266-020-00524-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/07/2020] [Indexed: 12/13/2022]
Abstract
There is no conclusive evidence regarding a causal relationship between periodontitis and atherosclerosis. In this study, we examined the microbiome in the oral cavity and atheromatous plaques from atherosclerosis patients with or without periodontitis to investigate the role of oral bacteria in the formation of atheromatous plaques. We chose four patients with and without periodontitis, who had undergone carotid endarterectomy. Bacterial samples were extracted from the tongue surface, from periodontal pocket (during the oral examination), and from the atheromatous plaques (APs). We investigated the general and oral conditions from each patient and performed next-generation sequencing (NGS) analysis for all bacterial samples. There were no significant differences between both groups concerning general conditions. However, the microbiome patterns of the gingival pocket showed differences depending on the absence or presence of periodontitis, while those of the tongue surface were relatively similar. The microbiome pattern of the atheromatous plaques was entirely different from that on the tongue surface and gingival pocket, and oral bacteria were seldom detected. However, the microbiome pattern in atheromatous plaques was different in the presence or absence of periodontitis. These results suggested that oral bacteria did not affect the formation of atheromatous plaques directly.
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Cho DH, Song IS, Choi J, Gwon JG. Risk of peripheral arterial disease in patients with periodontitis: A nationwide, population-based, matched cohort study. Atherosclerosis 2020; 297:96-101. [DOI: 10.1016/j.atherosclerosis.2020.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/02/2020] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
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Xu S, Song M, Xiong Y, Liu X, He Y, Qin Z. The association between periodontal disease and the risk of myocardial infarction: a pooled analysis of observational studies. BMC Cardiovasc Disord 2017; 17:50. [PMID: 28143450 PMCID: PMC5286862 DOI: 10.1186/s12872-017-0480-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/20/2017] [Indexed: 02/07/2023] Open
Abstract
Background Several meta-analyses have indicated that periodontal disease (PD) are related to cardiovascular diseases (CVDs). However, the association between PD and myocardial infarction (MI) remains controversial. Here we aimed to assess the association between PD and MI by meta-analysis of observational studies. Methods PubMed, EMBASE and the Cochrane Library were searched through July, 2016. Observational studies including cohort, cross-sectional and case–control studies reporting odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CIs) were included in the analysis. Either fixed or random-effects model were applied to evaluate the pooled risk estimates. Sensitivity and subgroup analyses were also carried out to identify the sources of heterogeneity. Publication bias was assessed by the Begg’s, Egger’s test and funnel plot. Results We included 22 observational studies with 4 cohort, 6 cross-sectional and 12 case–control studies, including 129,630 participants. Patients with PD have increased risk of MI (OR 2.02; 95% CI 1.59-2.57). Substantial heterogeneity in risk estimates was revealed. Subgroup analyses showed that the higher risk of MI in PD patients exists in both cross-sectional studies (OR 1.71; 95% CI 1.07-2.73) and case–control studies (OR 2.93; 95% CI 1.95-4.39), and marginally in cohort studies (OR 1.18; 95% CI 0.98-1.42). Further, subgroup meta-analyses by location, PD exposure, participant number, and study quality showed that PD was significantly associated with elevated risk of MI. Conclusion Our meta-analysis suggested that PD is associated with increased risk of future MI. However, the causative relation between PD and MI remains not established based on the pooled estimates from observational studies and more studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12872-017-0480-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuai Xu
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, 400037, Chongqing, China
| | - Mingbao Song
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Yu Xiong
- Department of Stomatology, Southwest Hospital, Third Military Medical University, 400038, Chongqing, China
| | - Xi Liu
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Yongming He
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Zhexue Qin
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China.
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Asai K, Yamori M, Yamazaki T, Yamaguchi A, Takahashi K, Sekine A, Kosugi S, Matsuda F, Nakayama T, Bessho K. Tooth loss and atherosclerosis: the Nagahama Study. J Dent Res 2014; 94:52S-58S. [PMID: 25406168 DOI: 10.1177/0022034514559127] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Several epidemiologic studies have suggested that oral disease is a risk factor for cardiovascular disease (CVD). However, whether a clinically significant association exists between the 2 disorders remains controversial. Here, we investigated the association between tooth loss, as an indicator of oral disease, and arterial stiffness, as a marker of atherosclerosis, in Japanese adults. Cross-sectional data were collected for 8,124 persons aged 30 to 75 y with no history of tooth loss for noninflammatory reasons, such as orthodontic treatment, malposition, and trauma. Participants received a comprehensive dental examination and extensive in-person measurements of CVD risk factors, and arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). We examined the association between CAVI and tooth loss using general linear models with adjustment for age, sex, body mass index, smoking status, hemoglobin A1c, and a history of insulin or hypoglycemic medication depending on the model. In addition, we performed an analysis that included interaction terms of the centered variables tooth loss, sex, and age. The results of the multiple regression analysis that included the interaction terms detected that the relationship between CAVI and tooth loss was dependent on sex, with only men showing a positive correlation (β for interaction = 0.04; 95% confidence interval, 0.02-0.06). The findings from this study suggest that a linear relationship exists between tooth loss and degree of arterial stiffness and that the association differed depending on sex.
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Affiliation(s)
- K Asai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Yamori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Yamazaki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Yamaguchi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Takahashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Sekine
- EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - S Kosugi
- Department of Biomedical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - F Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - K Bessho
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Noguchi S, Toyokawa S, Miyoshi Y, Suyama Y, Inoue K, Kobayashi Y. Five-year follow-up study of the association between periodontal disease and myocardial infarction among Japanese male workers: MY Health Up Study. J Public Health (Oxf) 2014; 37:605-11. [PMID: 25293424 DOI: 10.1093/pubmed/fdu076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An association between chronic oral infections and coronary heart disease has been suggested. METHODS The study participants were male employees aged 36-59 years. Data were extracted from the MY Health Up Study, comprising a baseline questionnaire survey and succeeding annual health examinations for financial firm workers in Japan. Using a self-administered questionnaire at baseline, participants' oral status was classified into three types of periodontal indicators: (i) periodontal score, (ii) periodontitis and (iii) tooth loss (<5 and ≥5 teeth). An incidence of myocardial infarction (MI) was determined by annual health examination records. RESULTS Of the 4037 candidates for follow-up in the baseline year of 2004, 3081 males were eligible for the analysis, 17 of whom experienced MI in the subsequent 5 years. The periodontal score model was associated with an increase in developing MI [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.29-3.44], after adjusting for other confounding variables. The periodontitis (OR = 2.26, 95% CI = 0.84-6.02) and tooth loss (OR = 1.97, 95% CI = 0.71-5.45) models showed similar trends, although the difference was not significant. CONCLUSIONS Periodontal disease may be a mild but independent risk factor for MI among Japanese male workers.
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Affiliation(s)
- Satomi Noguchi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yuji Miyoshi
- Division of Health Promotion, Meiji Yasuda Life Insurance Company, Tokyo, Japan
| | - Yasuo Suyama
- Meiji Yasuda Shinjuku Medical Center, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Kazuo Inoue
- Department of Community Medicine, Chiba Medical Center, Teikyo University School of Medicine, Chiba, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Kaneto C, Toyokawa S, Miyoshi Y, Suyama Y, Kobayashi Y. Long-term weight change in adulthood and incident diabetes mellitus: MY Health Up Study. Diabetes Res Clin Pract 2013; 102:138-46. [PMID: 24139847 DOI: 10.1016/j.diabres.2013.08.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/28/2013] [Accepted: 08/23/2013] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether long-term weight/BMI change in adulthood has a significant impact on the incidence of diabetes, independent of attained weight status. METHODS A number of 13,700 participants (2962 men and 10,738 women) aged 36 to 55 years were followed for up to 5 years using data from annual health checkups. Incident cases of diabetes were identified from self-reports or single fasting plasma glucose measurements (≥7.0 mmol/l). Weight/BMI change was calculated from participants' weight/BMI values at age 20 years and weight/BMI values at a given point during follow-up and used as a time-dependent variable in age-stratified multivariate Cox proportional hazards models. RESULTS During the 5 year follow-up, 408 participants (137 men and 271 women) developed diabetes. Even after adjusting for BMI during follow-up and other possible confounders, weight/BMI gain since age 20 years was significantly associated with an increased risk of developing diabetes. The hazard ratios were: 2.30 (95% confidence interval (CI): 1.31-4.04) for those who gained 6.0 to <10.0 kg and 3.09 (95% CI: 1.79-5.34) for those who gained ≥10.0 kg [reference: <2.0 kg change]; and 2.61 (95% CI: 1.58-4.31) for those who gained 3.0 to <5.0 kg/m(2) and 3.70 (95% CI: 2.22-6.16) for those who gained ≥5.0 kg/m(2) [reference: <1.0 kg/m(2) change]. CONCLUSIONS The results indicate that long-term weight/BMI gain in adulthood is a significant predictor for the development of diabetes, independent of attained weight status. Because weight gain within the normal weight range could increase the risk of diabetes, non-obese people should also be warned against possible weight gain.
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Affiliation(s)
- Chie Kaneto
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, Taubert KA, Newburger JW, Gornik HL, Gewitz MH, Wilson WR, Smith SC, Baddour LM. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation 2012; 125:2520-44. [PMID: 22514251 DOI: 10.1161/cir.0b013e31825719f3] [Citation(s) in RCA: 669] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A link between oral health and cardiovascular disease has been proposed for more than a century. Recently, concern about possible links between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) has intensified and is driving an active field of investigation into possible association and causality. The 2 disorders share several common risk factors, including cigarette smoking, age, and diabetes mellitus. Patients and providers are increasingly presented with claims that PD treatment strategies offer ASVD protection; these claims are often endorsed by professional and industrial stakeholders. The focus of this review is to assess whether available data support an independent association between ASVD and PD and whether PD treatment might modify ASVD risks or outcomes. It also presents mechanistic details of both PD and ASVD relevant to this topic. The correlation of PD with ASVD outcomes and surrogate markers is discussed, as well as the correlation of response to PD therapy with ASVD event rates. Methodological issues that complicate studies of this association are outlined, with an emphasis on the terms and metrics that would be applicable in future studies. Observational studies to date support an association between PD and ASVD independent of known confounders. They do not, however, support a causative relationship. Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes.
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Kaneto C, Toyokawa S, Inoue K, Inoue M, Senba T, Suyama Y, Miyoshi Y, Kobayashi Y. Association between periodontal disease and peptic ulcers among Japanese workers: MY health up study. Glob J Health Sci 2012; 4:42-9. [PMID: 22980150 PMCID: PMC4777052 DOI: 10.5539/gjhs.v4n2p42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 01/28/2012] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association between periodontal disease and peptic ulcers in a working population. METHODS Self-administered questionnaires were distributed to all employees of a large insurance company in Japan. The questionnaire asked about their health status and lifestyle habits. Peptic ulcer was defined as either stomach ulcer, duodenal ulcer, or both. For the evaluation of periodontal disease, three indices were used: (a) loss of five or more teeth, (b) having been told of having periodontitis, and (c) periodontal risk score. RESULTS Of the eligible 28 765 subjects analyzed, peptic ulcer was present in 397 (1.4%). The results of bivariate analyses showed that a significantly higher proportion of subjects with peptic ulcer reported that they lost five or more teeth (35.3 vs. 17.4%, p<0.001) or that they were told they had periodontitis (33.5 vs. 20.7%, p<0.001). Moreover, the periodontal risk score was higher for those with peptic ulcer than those without (mean 0.83 vs. 0.59, p<0.001). In multivariate logistic regression analyses, statistical associations were found between the presence of peptic ulcer and loss of five or more teeth (odds ratio (OR): 1.41, 95% confidence interval (CI): 1.13-1.76, p<0.01), having been told of having periodontitis (OR: 1.28, 95% CI: 1.03-1.59, p<0.05), and a 1-point increase in the periodontal risk score (OR: 1.17, 95% CI: 1.04-1.30, p<0.01), respectively. CONCLUSION Modest but statistically significant associations were found between the self-reported measures of periodontal disease and peptic ulcers.
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Affiliation(s)
- Chie Kaneto
- Department of Public Health, Graduate School of Medicine, University of Tokyo, Bunkyoku, Japan.
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Moriyama Y, Toyokawa S, Kobayashi Y, Inoue K, Suyama Y, Sugimoto N, Miyoshi Y. [Comparison of lifestyle, mental stress, and medical check-up results between Tanshin-funin workers and workers living with their families]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2011; 54:22-28. [PMID: 22095205 DOI: 10.1539/sangyoeisei.e11001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES We conducted a comparative analysis of lifestyle, mental stress, and medical check-up results between tanshin-funin workers and workers living with their families. METHODS Study participants were 3,026 married men, aged 40-59 yr, who worked at a large financial firm in Japan. Tanshin-funin was defined as married men separated from their families due to workplace assignments, as determined by a self-administered questionnaire in 2004. Participants' lifestyle factors, including exercise, alcohol and smoking consumption, and dietary habits, and mental stress, including lack of vigor, irritability, fatigue, anxiety, depressed mood, and physical complaints, were examined using a self-administered questionnaire. Medical check-ups conducted in 2004 included measurements of BMI, SBP, DBP, FBS, GOT, GPT, γ-GTP, TC, TG, HDL, RBC, and WBC. RESULTS An analysis of lifestyle factors, using the χ(2) test, indicated that fewer tanshin-funin workers exercise, and that they had fewer regularly-scheduled meals. Tanshin-funin workers smoked more and consumed more alcohol, but ate fewer green and yellow vegetables. Tanshin-funin workers had fewer commuting hours and took fewer days off. Tanshin-funin workers also suffered more frequently from irritability and anxiety. A regression analysis, adjusted for age and smoking status, indicated that levels of TC, TG, and WBC for tanshin-funin workers were higher than workers living with their families. CONCLUSIONS The lifestyle habits of tanshin-funin workers, such as dietary habits, were worse than those of workers living with their families, and tanshin-funin workers suffered from more irritability and anxiety. Clinical markers, such as dyslipidemia, were worse among tanshin-funin workers than among workers living with their families.
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Affiliation(s)
- Yoko Moriyama
- Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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Kebschull M, Demmer RT, Papapanou PN. "Gum bug, leave my heart alone!"--epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis. J Dent Res 2010; 89:879-902. [PMID: 20639510 DOI: 10.1177/0022034510375281] [Citation(s) in RCA: 319] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Evidence from epidemiologic studies suggests that periodontal infections are independently associated with subclinical and clinical atherosclerotic vascular disease. Although the strength of the reported associations is modest, the consistency of the data across diverse populations and a variety of exposure and outcome variables suggests that the findings are not spurious or attributable only to the effects of confounders. Analysis of limited data from interventional studies suggests that periodontal treatment generally results in favorable effects on subclinical markers of atherosclerosis, although such analysis also indicates considerable heterogeneity in responses. Experimental mechanistic in vitro and in vivo studies have established the plausibility of a link between periodontal infections and atherogenesis, and have identified biological pathways by which these effects may be mediated. However, the utilized models are mostly mono-infections of host cells by a limited number of 'model' periodontal pathogens, and therefore may not adequately portray human periodontitis as a polymicrobial, biofilm-mediated disease. Future research must identify in vivo pathways in humans that may (i) lead to periodontitis-induced atherogenesis, or (ii) result in treatment-induced reduction of atherosclerosis risk. Data from these studies will be essential for determining whether periodontal interventions have a role in the primary or secondary prevention of atherosclerosis.
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Affiliation(s)
- M Kebschull
- Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, 630 W 168th Street, PH-7-E-110, New York, NY 10032, USA
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