停經後婦女骨質密度與牙周疾病相關性探討

研究背景中華民國老年醫學會曾經調查台灣地區骨質疏鬆症的罹患率，發現台灣地區65歲以上人口中，每九人即有一人罹患骨質疏鬆症，其中女性多於男性，65歲以上女性每四人當中即有一人發生骨質疏鬆症，其中尤以停經更年期後佔多數，大約有25％會發生骨質疏鬆症。目前有愈來愈多的醫學研究顯示，骨質疏鬆症與牙周疾病兩者之間有某些程度的相關聯。因為國內對於此兩種疾病的相關研究報告有限，因此本研究以停經後婦女骨質密度與牙周狀況調查來進行相關研究分析，以瞭解兩者之間的相關性。研究目的瞭解骨科停經後婦女病患骨質密度現況與牙周疾病現況。研究骨質疏鬆症與牙周疾病的相關性。研究方法本研究設計以南部某區域教學醫院停經後婦女骨科患者，且擁有20顆牙齒以上，共計100人為研究對象。進行「停經後婦女健康生活觀念調查」問卷，骨質密度檢查與牙周狀況檢查。統計分析採用JMP及SAS統計軟體，進行分析。研究結果本研究將影響骨質疏鬆與牙周病的可能干擾因子如：年齡、身體質量指數（BMI）、心血管疾病及牙菌斑指數等變項放入分析模組後，結果顯示社區牙周指數大於等於4mm者是社區牙周指數小於4mm者2.38倍(95% CI=0.72-7.86)的機率有骨質疏鬆症者，同時是1.67倍(95%CI=0.41-6.71)的機率會骨質稀鬆，但其結果在統計學上未達顯著性。將年齡、身體質量指數、心血管疾病與牙菌斑指數等變項放入分析模組後，結果顯示牙周附連喪失每增加1mm則會有6.85倍(95%CI=2.68-17.53)的機率有骨質疏鬆症者，同時是4.70倍(95%CI=2.03-10.84)的機率會骨質稀鬆。結論雖然由本研究中，無法得知骨質密度與牙周狀況的相關性，但可得知二者之間有關聯性；在骨質疏鬆症、骨質稀鬆與牙周附連喪失彼此之間有顯著的相關性，牙周附連喪失狀況愈差者，其骨質密度也相對的減少。

關鍵字

停經後；骨質密度；牙周病

並列摘要

Background The Association of Geriatric has reported the prevelance of osteoporosis in Taiwan for the population over the age of 65 was average one of nine persons, in which women are more than men. In additions, almost 25 percent of postmenopausal women has osteoporosis. In current literature, more and more medical researches reveal that osteoporosis is related to periodontal disease. However, limited related research has been done in Taiwan. Objectives The purpose of this study was to investigate of the status of bone mineral density and periodontal disease in postmenopausal women and analysis of relationship of osteoporosis and periodontal disease. Methods Participants were recruited from Department of Orthopaedic in a regional teaching hospital of southern Taiwan. There were 100 postmenopausal women who had more than twenty teeth collected. Each completed a questionnaire survey of “Post-menopausal women healthy living concept”, and periodontal condition and bone mineral density were examined. Statistical analyses were conducted by JMP and SAS. Result The association of osteoporosis, osteopenia and community periodontal index after adjusting possible confounding factors (age, body mass index, cardiovascular disease and plaque index), osteoporosis, osteopenia and community periodontal index revealed positive relationship. People with CPI greater or equal to 4mm have 2.38 times (95% CI=0.72-7.86) of the risk for having osteoporosis than people with CPI less than 4mm. Correspondingly, it is 1.67 times (95% CI=0.41-6.71) of the chance for having osteopenia. The association of osteoporosis, osteopenia and periodontal attachment loss after adjusting osteoporosis, osteopenia and periodontal attachment loss revealed singiticant (p-value < .0001) positive relationship. The chance of having osteoporosis confounding factors (age, body mass index, cardiovascular disease and plaque index). Conclusion In this study, no statistical signiticant evidence was found between osteoporosis, osteopenia and community periodontal index. However, the attachment loss was signiticantly associated with osteoporosis and osteopenia. The increasing of the attachment was related to low bone mineral density, osteoporosis and osteopenia.