北京市石景山コミュニティにおける中高年の慢性歯周炎と頸動脈内膜厚との関連性について検討した

[Association between chronic periodontitis and carotid intima-media thickness of middle-aged and older adults in Shijingshan community of Beijing].

• Y Liu
• Q X Luan

抄録

目的:

北京市石景山地区の中高年の歯周病と不顕性動脈硬化との関係を調査する。

OBJECTIVE: To investigate the relationship between periodontal disease and subclinical atherosclerosis in middle-aged and older adults in Shijingshan community of Beijing.

方法:

2005年から2010年にかけて、北京市の石景山コミュニティから合計830人の中高年成人を募集し、歯周炎の重症度によって2つのグループに分けた。質問紙、歯周検査、血液生化学検査、総頸動脈（CCA-IMT）、内頸動脈（ICA-IMT）、頸動脈分岐部（CB-IMT）を含む頸動脈内膜厚（CIMT）を測定し、歯周炎とCIMTの関連性を検討した。歯周炎とCIMTとの関連を、年齢、性別、教育水準、高血圧、高脂血症、肥満、喫煙、飲酒、糖尿病を調整した多変量ロジスティック回帰分析と共分散分析で評価した。さらに、歯周炎の定義（軽度歯周炎：AL≧3mmの割合＜10％、中等度歯周炎：AL≧3mmの割合10％～30％、重度歯周炎：AL≧3mmの割合≧30％）を用いて、歯周炎の分類の違いが結果に影響を与えるという仮説を検討しました。

METHODS: In 2005-2010, a total of 830 middle-aged and older adults were recruited from Shijingshan community of Beijing, who were divided into two groups by severity of periodontitis. A questionnaire, periodontal examination, blood biochemical examination, carotid intima-media thickness (CIMT), including common carotid artery (CCA-IMT), internal carotid artery (ICA-IMT) and carotid bifurcation (CB-IMT), were measured of each subject. The associations of periodontitis with CIMT was evaluated by multivariable Logistic regression analysis and analysis of covariance, adjusted for age, gender, education level, hypertension, hyperlipidemia, obesity, smoking, drinking, and diabetes. And then anther definition of periodontitis (mild periodontitis: percentage of AL≥3 mm <10%; moderate periodontitis: percentage of AL≥3 mm 10%-30%; severe periodontitis: percentage of AL≥3 mm ≥30%) was used to investigate the hypotheses that different classification of periodontitis would affect results.

結果:

中等度重度歯周炎の被験者は、軽度群に比べてCCA-IMT、ICA-IMT、CB-IMT、平均CIMTのレベルが有意に高いことが特徴であった。一変量解析では、中等度重度歯周炎はICA-IMT>0.9mmのリスクの増加と関連していた（調整済みOR=1.230、95％CI:1.058-1.452、P=0.031）。さらに、中等度歯周炎はCB-IMT>0.9 mm（調整済みOR=1.297、95%CI:1.117-1.753、P=0.011）、重度歯周炎はCB-IMT>0.9 mm（調整済みOR=1.771、95%CI:1.176-3.503、P=0.042）のリスクの増加と関連していた。

RESULTS: The subjects with moderate-severe periodontitis were characterized by significantly higher levels of CCA-IMT, ICA-IMT, CB-IMT and mean CIMT than the mild group. In the univariate analysis, moderate-severe periodontitis was associated with an increased risk of ICA-IMT>0.9 mm (adjusted OR=1.230, 95% CI: 1.058-1.452, P=0.031). Furthermore, moderate periodontitis was associated with an increased risk of CB-IMT>0.9 mm (adjusted OR: 1.297, 95%CI: 1.117-1.753, P=0.011) and severe periodontitis was associated with an increased risk of CB-IMT>0.9 mm (adjusted OR=1.771, 95%CI: 1.176-3.503, P=0.042) according to another classification of periodontitis.

結論:

我々のデータは、北京市石景山コミュニティの中高年における歯周炎とCIMTの関連性を示すものであり、歯周炎の分類の違いが結果に影響を与えることを示している。

CONCLUSION: Our data provided evidence that periodontitis was associated with CIMT among middle-aged and older adults in Shijingshan community of Beijing and different periodontitis classification would affect the results.