歯周炎患者における歯周炎の重症度と血圧の関連に及ぼす年齢と全身性炎症の影響

Effect of age and systemic inflammation on the association between severity of periodontitis and blood pressure in periodontitis patients.

抄録

背景:

歯周炎は高血圧と密接に関連する歯周炎症性疾患である。しかし、年齢と全身性炎症の役割は不明である。本研究では、歯周炎患者の歯周炎の重症度と血圧の関連に及ぼす年齢と全身性炎症の影響を検討した。

BACKGROUND: Periodontitis is a periodontal inflammatory disease closely related to hypertension. However, the role of age and systemic inflammation is unclear. This study examined the effect of age and systemic inflammation on the association between severity of periodontitis and blood pressure in periodontitis patients.

方法:

この横断的臨床研究は、2020年1月から2023年7月までに首都医科大学北京朝陽病院で治療を受けた歯周炎患者を対象とした。包括基準と除外基準を用いて歯周炎患者を対象とし、基本情報、血圧、歯周検査指標、生化学検査指標のデータを収集した。患者を血圧でグループ分けし、2群間の基本情報、血液指標、歯周検査指標の差を独立標本T検定で比較した。PBOPを独立変数，収縮期血圧（SBP）と拡張期血圧を従属変数，いくつかの指標を共変数として，それらの関係を線形回帰により検討した．交互作用を用いて、歯周炎および高血圧における年齢と全身性炎症の関係を調べた。

METHODS: This cross-sectional clinical study included periodontitis patients treated at Beijing Chaoyang Hospital, Capital Medical University from January 2020 to July 2023. Patients with periodontitis were included using inclusion and exclusion criteria, and data on basic information, blood pressure, periodontal examination indicators, and biochemical examination indicators were collected. Patients were grouped by blood pressure, and differences in basic information, blood indexes, and periodontal examination indexes between the two groups were compared by independent sample T-test. With PBOP as independent variables, systolic blood pressure (SBP) and diastolic blood pressure as dependent variables, and several indexes as covariables, the relationship between them was studied by linear regression. The interaction was used to explore the relationship between age and systemic inflammation in periodontitis and hypertension.

結果:

合計144名の歯周炎患者が登録された。完全調整分析において、プロービング時に出血を認めた部位の割合（PBOP）は、全体群においてSBPと有意に関連していた（B=10.08, p=0.027）。50歳以上の患者ではPBOPはSBPと有意な関連を示したが、50歳未満の患者ではPBOPは有意な関連を示さなかった（交互作用についてはp=0.018）。PBOPとSBPの関連は、全身性免疫炎症指数が高い患者ほど強かった。全身性免疫炎症指数400以上群と400未満群におけるPBOPの回帰係数は、それぞれ16.61（95％CI、3.32-29.90；p＝0.015）と13.69（95％CI、1.15-26.23；p＝0.033）であった（交互作用についてはp＝0.047）。同様の結果が、全身性炎症反応指数≧9群と＜9群で観察された（B＝17.04（95％CI、2.66-31.42、p＝0.021）および13.98（95％CI、1.94-26.01、p＝0.024、交互作用についてp＝0.028）。

RESULTS: A total of 144 patients with periodontitis were enrolled. In fully adjusted analyses, the percentage of site with bleeding on probing (PBOP) was significantly associated with SBP (B = 10.08, p = 0.027) in the overall group. In patients 50 years or older, but not in those younger than 50, PBOP remained significantly associated with SBP (p = 0.018 for interaction). The strength of association between PBOP and SBP was greater in patients with higher systemic immune-inflammation index. The regression coefficients of PBOP in the systemic immune-inflammation index ≥ 400 and < 400 groups were 16.61 (95% CI, 3.32-29.90; p = 0.015) and 13.69 (95% CI, 1.15-26.23; p = 0.033), respectively (p = 0.047 for interaction). Similar results were observed in the systemic inflammation response index ≥ 9 and < 9 groups (B = 17.04 (95% CI, 2.66-31.42, p = 0.021) and 13.98 (95% CI, 1.94-26.01, p = 0.024 respectively; p = 0.028 for interaction).

結論:

本研究は、歯周炎の重症度とSBPとの間に有意な関連があることを示し、それは年齢と全身性炎症によって修飾された。

CONCLUSIONS: This study indicates a significant association between the severity of periodontitis and SBP, which was modified by age and systemic inflammation.