透過您的圖書館登入
IP:44.221.83.121
  • 學位論文

社區牙周指數、血液中脂聯素和高敏感度C反應蛋白濃度與心血管疾病的相關性探討

The association between community periodontal index, plasma levels of high-sensitivity C-reactive protein and adiponectin, and cardiovascular disease.

指導教授 : 林英助
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


中文摘要 目的:探討社區牙周指數(community periodontal index: CPI)、牙菌斑指數(plaque index: PI)、缺牙數目、血液中脂聯素(adiponectin)和高敏感度C-反應蛋白(hs-CRP)濃度與心血管疾病的相關性。 方法:從大同醫院社區健康檢查收集對照組63人和心臟內科門診收集心血管疾病患者101人,在簽署同意書後以問卷收集基本資料和潛在干擾因子的資料,並抽血5-8ml進行生化檢測,以兩位經一致化和標準化訓練的牙醫師收集社區牙周指數(community periodontal index: CPI)和牙菌班指數(plaque index: PI)來評估口腔健康狀態,最後以SPSS 19.0統計軟體分析其相關性。 結果:本研究調查對象平均年齡為57.55 ±11.83歲。有抽菸習慣、已婚、年齡≥57歲、HbA1c>7%、CPI ≥ 3、total cholesterol ≥ 200mg/dL、fasting glucose ≥ 116mg/dL、adiponectin < 24μg/ml、PI ≥ 2、hs-CRP ≥ 5mg/L、TG ≥ 160 mg/dL、LDL≥ 130 mg/dL和缺牙顆數≥4等的頻率分佈在疾病組顯著高於對照組。性別和HDL≥85mg/dL的頻率分佈在疾病組與對照組間無顯著差異。多變項邏輯式回歸分析顯示,心血管疾病與年齡≥57歲( OR=5.47, 95% CI=1.75 ~17.12)、CPI ≥ 3 (OR = 5.40, 95% CI = 2.26 ~ 12.92)、hs-CRP≥ 5.0mg/L ( OR = 2.71, 95% CI =1.50~9.19)、PI≥ 2 ( OR = 4.88, 95% CI = 1.50~15.90)、缺牙顆數≥ 4 ( OR = 4.09, 95% CI = 1.15~ 4 14.61)、HbA1c ≥ 7.0% ( OR=5.91, 95% CI = 2.07~ 16.88)、TG ( OR = 4.15, 95% CI =1.16~14.85 )、fasting glucose≥ 116 mg/dL (OR = 5.28, 95% CI =2.56~13.28 )等因子有明顯相關,但與adiponectin < 24μg/ml ( OR = 1.95, 95% CI = 0.93 ~4.05 )、total cholesterol ≥ 200 mg/dL ( OR = 2.78, 95% CI = 0.87 ~8.88) 等因子無顯著相關。 結論:我們建議CPI≥3、缺牙顆數≥ 4、PI≥ 2、hs-CRP≥ 5.0mg/L與心血管疾病的狀態有關,但adiponectin< 24μg/ml與心血管疾病無顯著相關,然此相關性仍有待更多的研究加以驗證。

並列摘要


英文摘要 Objectives: To determine the association between community periodontal index (CPI), plaque index(PI), number of teeth loss plasma levels of adiponectin and high sensitive C-reactive protein (hs-CRP), and cardiovascular disease (CVD). Methods:Sixty and three controls were recruited from community healthy survey, and 101 CVD patients were recruited from the Division of Cardiology, Municipal Ta-Tung Hospital, Kaohsiung, Taiwan. A standardized questionnaire was applied to collect demographic and potential confounding variables after the inform consent was obtained. A total of 5-8 ml of peripheral blood was collected for the biochemistry tests. CPI values and plaque index (PI) were assessed by two well-trained dentist. After the data linkage, statistical methods were applied to determine the associations. Results:The mean age of all participants was 57.55 ± 11.83. The frequencies of smokers , status of married , age≥ 57, HbA1c ≥ 7%, CPI ≥ 3, number of tooth lost ≥4, total cholesterol ≥ 200 mg/dL, fasting glucose ≥ 116mg/dL, adiponectin < 24μg/ml, PI ≥ 2, hs-CRP ≥ 5mg/L, TG ≥ 160 mg/dL, and LDL ≥ 160 mg/dL were significantly higher in CVD patients than those in control group. No significant differences in frequency distributions of gender and HDL ≥ 85 mg/dL were found between the CVD group and controls. Multivariate logistic regression analysis showed that age≥ 57 (OR=5.47, 95% CI=1.75~17.12), CPI ≥ 3 (OR = 5.40, 95% CI = 2.26~12.92), hs-CRP ≥ 6 5mg/L (OR = 2.71, 95% CI =1.50~9.19), PI≥2 ( OR = 4.88, 95% CI = 1.50~15.90), number of tooth lost ≥ 4 (OR=4.09, 95% CI =1.15 ~14.61), HbA1c ≥ 7.0% (OR= 5.91, 95% CI = 2.07~16.88), TG ≥ 160 mg/dL (OR=4.15, 95% CI = 1.16~14.85), fasting glucose≥ 116 mg/dL (OR = 5.28, 95% CI =2.56~13.28 ) were associated with an increase of CVD status. However, no such relationship was found in the decrease of adiponectin < 24μg/ml (OR = 1.95, 95%CI = 0.93~4.05 ), total cholesterol ≥ 200 mg/dL (OR =2.78, 95% CI= 0.87 ~8.88). Conclusion:We suggested that CPI ≥ 3, number of tooth lost ≥ 4 , PI≥ 2 and hs-CRP ≥ 5 mg/L are risk factors for the increase of CVD status, but no such relationship was found in the the decrease of plasma adiponectin level . More studies are needed to validate these relationships.

參考文獻


參考文獻
1. Pan, W.H., et al., Prevalence, awareness, treatment and control of hypertension in Taiwan: results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. J Hum Hypertens, 2001. 15(11): p. 793-8.
2. 行政院衛生署國民健康局, 吸菸對健康的危害. 2012.
3. Mattila, K.J., et al., Association between dental health and acute myocardial infarction. BMJ, 1989. 298(6676): p. 779-81.
4. Tabeya, T., et al., [Relationship of metabolic syndrome and insulin resistance with microalbuminuria in senior citizens of rural communities in Japan --the Tanno and Sobetsu study--]. Nihon Ronen Igakkai Zasshi, 2008. 45(3): p. 302-7.

延伸閱讀