- 期刊
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 Adiponectin and High-Sensitivity C-Reactive Protein, and Cardiovascular Disease
摘要
目的：探討社區牙周指數（community periodontalindex; 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（high sensitive C-reactive protein; hs-CRP）濃度與心血管疾病的相關性。方法：從大同醫院健康檢查單位收集對照組的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平擾因子的資料，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和牙菌班指數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57.6 ± 11.8歲。有抽菸習慣、已婚、年齡≧57歲、HbA1c≧7%、CPI≧3、缺牙顆數≧4、total cholesterol≧200 mg/dL、fasting glucose≧116 mg/dL、adiponectin＜24μ g/mL、PI≧2、hs-CRP≧5 mg/L、TG≧160 mg/dL和LDL≧130 mg/dL等的頻率分佈在心血管疾病組顯著高於對照組。性別和HDL＜85 mg/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，CPI≧3（OR=5.40, 95% CI=2.26~12.92）、hs-CRP≧5 mg/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=1.15~14.61）與心血管疾病有明顯相關，但與adiponectin＜24 μg/mL （OR=1.95, 95% CI=0.93~4.05）無顯著相關。結論：我們建議CP≧3、缺牙顆數≧4、PI≧2、hs-CRP≧5 mg/L與心血管疾病的狀態有關。但adiponectin＜24μ g/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
Objectives: Our aims were to determine the association between community periodontal index (CPI), plaque index (PI), number of tooth 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 hospital visiting for health examination, 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. The CPI and PI values were assessed by two well-trained dentists. After the data merged, statistical methods were applied to determine the association by SPSS 19.0. Results: The mean age of all participants was 57.6±11.8 years old. The frequency distributions of smokers, status of married, age≧57, HbAlc≧%, CPI≧3, number of tooth lost≧4, total cholesterol≧200 mg/dL, fasting glucose≧116mg/dL, adiponectin＜24μg/mL, PI≧2, hs-CRP≧5 mg/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 CPI≧3 (vs. ＜3, OR=5.40, 95% CI=2.26~12.92), hs-CRP≧5 mg/L (vs.＜ 5, OR=2.71, 95% CI=1.50~9.19), PI≧2 (vs.＜2, OR=4.88, 95% CI=1.50~15.90), number of tooth lost＞4 (vs. ＜4, OR=4.09, 95% CI=1.15~14.61), were associated with an increase risk of CVD disease status. However, no such relationship was found in the adiponectin＜24μg/mL(vs.＞24, OR=1.95, 95% CI=0.93~4.05). Conclusion: We suggested that CPI≧3, number of tooth lost≧4, PI≧2 and hs-CRP≧5 mg/L are linked with the CVD disease status, but no such relationship was found in the decrease of plasma adiponectin level. More studies are needed to validate these relationships.