The Association between Periodontal Disease and Renal Disease Occurrence : A Retrospective Cohort Study

Seon-Ju Sim,MinHee Hong,Ja-Young Moon,Hye-Sun Shin 대한치과위생학회 2024 대한치위생과학회지 Vol.7 No.1

연구배경: 치주질환 상태와 신장질환과의 연관성에 대한 연구는 아직 명확한 근거가 없는 실정이다. 본 연구에서 는 건강보험공단자료를 이용하여 치주질환이 신장질환 발생을 증가시키는지 여부를 후향적 코호트 연구설계로 분석하였다. 연구방법: 국민건강보험공단 표본코호트 데이터를 이용하여 203,538명의 국내 성인을 대상으로 2002년부터 2015년까지의 자료를 활용하였다. 치주질환의 정의는 치과의사에 의해 진단된 치주질환 여부 변수와 치주질환으 로 인해 치과를 방문한 횟수(0회, 1회, 2회, 3회 방문)를 주 독립변수로 설정하였다. 신장질환은 국제질병분류 10차 개정판 코드를 사용하여 진단된 급성 신장질환과 유전성 신장질환을 제외한 신장질환을 포함하였다. 연구의 기 초조사는 3년(2002년-2004년)으로 설정하였고, 추적조사기간은 11년(2005년-2015년)으로 설정하였다. 연구결과: 11년의 추적기간동안, 전체 203,538명 중 19,868명이 발생하였다. 나이, 성별, 수입, 음주, 흡연, 신 체활동, 당뇨병, 고혈압, 비만, 고지혈증, 허혈성 심장질환, 치주치료를 보정한 결과, 치주질환은 신장질환 발생 위험을 1.04배 증가시켰다. (adjusted hazard ratio [aHR] = 1.04, 95% CI = 1.01 to 1.08). 또한 치주질환으로 인한 치 과 방문 빈도가 많을수록 신장질환 발생 위험이 증가하는 용량-반응 경향을 보였다 (aHR = 1.02, 95% CI = 1.00 to 1.06 for 1회 방문; aHR = 1.08, 95% CI = 1.04 to 1.13 for 2회 방문; aHR = 1.11, 95% CI = 1.03 to 1.21 for 3회 방문). 결론: 본 후향적 코호트 연구 결과 치주질환은 신장질환의 위험을 발생시킨다는 결과를 보여주었다. Background: Research on the association between renal disease and periodontal conditions has yet to yield definitive results. In this study, we analyzed whether periodontal disease increases the risk of developing renal disease using Korean national cohort data over a period of 11 years. Methods: From 2002 to 2015, a retrospective follow-up investigation was conducted on the 203,538 Korean population using the National Health Insurance Service-National Sample Cohort. Periodontal disease and renal disease were identified through diagnoses using the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes. The assessment of periodontal status involved considering the number of dental visits related to periodontal disease during the baseline 3-year period. Results: During the 11-year follow-up period, renal disease occurred in 19,868 out of the total 203,538 individuals. After adjusting for age, gender, income, smoking, drinking, physical activity, diabetes, hypertension, obesity, hypercholesterolemia, ischemic heart disease, and advanced periodontal treatment, periodontal disease increased the risk of renal disease occurrence by 1.04 times (adjusted hazard ratio [aHR] = 1.04, 95% CI = 1.01 to 1.08). Additionally, a higher frequency of dental visits attributed to periodontal disease was associated with an increased risk of renal disease,exhibiting a dose-response trend (aHR = 1.02, 95% CI = 1.00 to 1.06 for once; aHR = 1.08, 95% CI = 1.04 to 1.13 for two times; aHR = 1.11, 95% CI = 1.03 to 1.21 for three times). Conclusions: Our data confirmed that periodontal disease is associated witha higher incidence of renal disease.

일부 농어촌 지역 성인의 흡연 행태와 치주질환에 관한 조사연구 - 태안군 지역을 중심으로 -

김은희 ( Kim Eun-hee ),문선정 ( Moon Seon-jeong ) 한국도서(섬)학회 2024 한국도서연구 Vol.36 No.4

This study was conducted to analyze the relationship between smoking and periodontal disease in adults living in Taean, Chungcheongnam-do, some rural areas, to provide basic data for improving the oral health of smokers in the future. During the study period, a self-written questionnaire survey was conducted from January to July 2024, and the survey method was distributed and collected using collective surveys, distribution surveys, and mail-in, and 225 copies were finally analyzed. For data analysis, reliability tests were performed to find out the internal consistency of the attributes of subjective periodontal disease symptoms using SPSS/Win 25.0, frequency analysis was performed for general characteristics and smoking behavior, and x2-test was performed for periodontal disease according to general characteristics and smoking behavior. Regression analysis was conducted to find out the relationship between smoking behavior and periodontal condition, and multiple regression analysis was conducted to identify the factors that the sub-factors of subjective periodontal disease symptoms affect smoking behavior areas. As for the gender, males were somewhat larger, distribution by age group was 40-59, and high school graduation accounted for a high proportion of education levels. The higher the age, the higher the periodontal disease, the higher the periodontal disease in high school graduation, the higher the health status, the higher the periodontal health, the higher the normal, bad, and the higher the frequency of drinking, the higher the periodontal disease. In the presence or absence of smoking, the periodontal disease was high in the presence or absence of smoking, and the periodontal health of not smoking was high in the case of past smoking experience. In terms of the amount of smoking, less than 10 cigarettes, 11-20 cigarettes, and 21 cigarettes or more had high periodontal disease, and the periodontal disease was high in all less than 1 year to 3 years, 4 to 6 years, and 6 years or more. In terms of the relationship between smoking behavior and periodontal condition, the risk of having periodontal disease was 2.785 times in the case of smoking or not, 2.513 times in the case of 11 to 20 cigarettes, and 2.746 times in the case of smoking period. Among the sub-factors of subjective periodontal disease symptoms, gum pain, gingival bleeding, gingival swelling, tooth discoloration, and bad breath were found to have a significant effect, and the better the gum pain, gingival bleeding, tooth discoloration, and bad breath, the lower the smoking behavior. For oral health management and prevention, it is necessary to be more aware of oral diseases caused by smoking along with regular checkups and continuous management. In particular, education on the harmfulness of smoking and prevention and management of periodontal diseases are considered necessary to prevent periodontal diseases.

Relationship between periodontal disease and stroke history in the geriatric population

이효정 대한치과의사협회 2006 대한치과의사협회지 Vol.44 No.10

The mean age of the population is growing older;with this aging comes the economic burden of caring for patients with age-related diseases. One of the most debilitating diseases of the elderly is cerebrovascular disease (CVD), or stroke. The World Health Organization’s (1980) definition of stroke is:“rapidly developing clinical signs of focal (at times global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin”(1). Another highly prevalent chronic disease of the elderly is periodontal disease. Based on the Third National Health and Nutrition Examination Survey (NHANES III), 53% of US adults, aged 30 to 90 years old, had 3 millimeters (mm) or more of attachment loss(2). The connection between cardiovascular disease and periodontal disease has been examined, but results have been obscure(3). For more than 10 years, this relationship has been the focus of many studies, with specific interest concentrating on the ability of dental infections to cause cardiovascular disease(4,5,6). In a meta-analysis of nine such longitudinal studies, Janket et al., concluded that there was a small but significant increase in the risk of cardiovascular disease among persons who had periodontal disease at baseline(7).While most of these studies suggest that periodontal disease was more frequent in coronary heart disease patients or ischemic stroke subjects(8,9,10,11), this finding is not universal, since other studies could not detect a statistically significant association(12,13,14,15). One of difficulty to find relationship between two diseases is that both disease share common important risk factors such as age and smoking, which could lead over adjusting as confounders in cross- sectional study(16,17). Other studies have shown that subjects with periodontal disease have elevated levels of cardiovascular risk factors, such as C-reactive protein, fibrinogen, and cholesterol(18,19,20). The relationship of periodontal disease to cardiovascular disease is further bolstered by several recent trials that have reported a decrease in systemic C-reactive protein (CRP) after periodontal treatment(21,22,23). Despite all of these studies, the association between periodontal disease and stroke remains unclear, and requires additional research until a clear consensus is reached. Few studies have been performed on large populations, with the most notable studies utilizing data from the NHANES I Follow-up Study(9,13,15,24). Since the information collected was from 1970 and was based on the Russell index with only visual examination and no periodontal probing, it may not accurately reflect the relationship of cumulative periodontal disease to stroke. In addition, no adjustment for C-reactive protein was available from NHANES I data. Hence, it is the aim of this study to use the more recent NHANES III study population to examine the association between cumulative periodontal disease and stroke history in the elderly.

성인 여성의 치주질환과 불안 및 우울증상에 관한 연구: 국민건강영양조사 제8기 2차년도(2020) 자료를 중심으로

가경환 학습자중심교과교육학회 2024 학습자중심교과교육연구 Vol.24 No.24

Objectives This study was conducted to investigate the demographic characteristics, periodontal disease, anxiety, and depression of adult women who are highly sensitive to psychological factors to find out the relationship between anxiety and depression and periodontal disease according to demographic characteristics. Methods The original data of the 8th 2nd year (2020) of the National Health and Nutrition Survey organized by the Korea Centers for Disease Control and Prevention were used, and 2,368 copies were finally analyzed after receiving approval for the use of the data after submitting documents such as the original data, user security pledge, etc. on the website (https://knhanes.kdca.go.kr ). For data analysis, a chi-square test was conducted using SPSS/Win 20.0 to find out the difference in demographic and oral health-related characteristics and periodontal diseases, and univariate regression analysis was conducted to find out the number of toothbrushes and periodontal diseases caused by the use of dental floss and interdental toothbrushes. Multiple logistic regression analysis was conducted to find out the effect of periodontal diseases on anxiety and depression, and multivariable logistic regression was conducted to find out the relationship between demographic characteristics and anxiety and depression experiences. Results The older the age, the higher the periodontal disease, and the higher the income and education level in the case of no experience of periodontal disease for the last one year. It was found that the number of times of brushing more than three times a day and the use of dental floss/interdental toothbrushes significantly increased the risk of periodontal disease, and periodontal disease significantly increased anxiety and depression. The experience of anxiety and depression was high in separation/divorce/divorce. The factor related to the experience of anxiety and depression was found to be marital status. Conclusions It will be necessary to improve professional accessibility such as counseling by developing and providing regular and continuous depression management and prevention programs that can be easily accessed by anyone and the need for regular periodontal management and effective oral health management education to efficiently manage periodontal diseases.

The prevalence of periodontal disease according to oral care habits

( Do-hee Kim ),( Hyun-ju Chung ),( Ok-su Kim ) 조선대학교 치의학연구원 2017 Oral Biology Research (Oral Biol Res) Vol.41 No.2

Periodontal disease is one of the most common chronic diseases. Even though scaling and root planing are helpful for preventing periodontal disease, most people overlook it. So, the purpose of this study was to investigate oral care habits and the prevalence of periodontal disease to improve disease prevention and oral healthcare. This study was based on subpopulation of Donggu, Gwangju, Korea, for people older than 50, where oral examination and panoramic radiography were performed. Oral examination included O`Leary index, BOP (Bleeding on Probing), PD (Probing Depth), and CAL (Clinical Attatchment level). The subjects were 4025 people who responded to a oral health questionnaire. The prevalence of periodontal disease in the subjects were 10.3%, 56.1%, and 33.6% for slight, moderate, and severe periodontitis, respectively. The prevalence of periodontal disease was higher in men and older aged people in general. With respect to oral care habits, when subjects visited a dental center regularly and used oral hygiene devices, the ratio of the O`Leary Index was over 75%, the BOP was less than 25%, and severe PD and CAL (≥7 mm), and the prevalence of periodontal disease was less. Since the prevalence of periodontal disease was higher in male and increased with age, self-motivation about oral care habits, regular dental visits and oral care, such as scaling, root planning, and tooth brushing, are required for these groups. In addition, use of oral hygiene devices, such as dental floss and interdental brushes, is also.

Detection of Biomarkers for Periodontal Diseases Using Salivary Proteomics

조남표,김현철,김형섭,문경숙 대한구강악안면병리학회 2010 대한구강악안면병리학회지 Vol.34 No.3

Because of the irreversible nature of periodontal disease, early diagnosis is an important aspect of management of patients with periodontal disease. Human saliva is an attractive medium for disease diagnosis because its collection is noninvasive and simple. Analysis of saliva may be especially beneficial in the determination of current periodontal status and serve as means for the screening of periodontal disease. In the present study, we investigated potential biochemical markers in whole saliva samples for the screening of periodontal disease using proteomics technique. We enrolled five subjects each from four different groups on the basis of measures of periodontal health (healthy group, gingivitis group, chronic periodontitis group and aggressive periodontitis group). Eleven proteins in whole saliva samples were identified as differentially expressed proteins between the healthy and periodontal disease groups using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight /time-of-flight mass spectrophotometry (MADLI-TOF/TOF MS) approaches. Although the diagnostic value of oral fluid has been recognized for some time and potential biomarkers of periodontal disease have been identified in saliva,this, to our knowledge, is one of the first studies to examine large-scale proteomic profiling to identify the extent of periodontal destruction. Thus, this work provides an important framework for future efforts aimed at understanding salivary responses to periodontal destruction and predicting the future disease progression.

한국 성인의 전신건강상태와 치주질환과의 관련성 분석 - 2012년도 제 5기 국민건강영양조사 결과 분석 -

이선미,김기열,김진 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.2

The purpose of this study was to synthetically examine the relationship between systemic diseases and periodontal diseases. The data obtained from the Fifth Korea National Health and Nutrition Examination Survey were used. SPSS 18.0 for Windows was applied for statistical analysis. The surveyed data were analyzed by using independent sample t-test for the difference between Body Mass Index and clinical test according to the existence of periodontal disease, and X2 test for the relationship between periodontal disease and systemic disease. Multiple logistic regression analysis was used in order to figure out the influence upon the periodontal disease prevalence among general characteristics and systemic diseases. As results, the values of high density lipoprotein (HDL) and HBA1C were statistically significant, depending on the presence of periodontal disease. As for the relationship between periodontal disease and systemic disease, hypertension (odds ratio 1.362, p<.05), cardiovascular disease (odds ratio 2.118, p<.05), arthritis (odds ratio 1.289, p<.05) and cirrhosis (odds ratio 6.124, p<.05) were statistically significant. According to Multiple logistic regression analysis, gender (odds ratio 1.24, p<.05), alcohol intake (odds ratio 1.25, p<.05), cardiovascular diseases (odds ratio 1.56, p<.05), and liver cirrhosis (odds ratio 1.17, p<.05) were related to the prevalence of periodontal diseases. In conclusion, the systemic diseases such as cardiovascular system, diabetes, and liver diseases revealed to have relationship with periodontal disease. To strengthen oral health education is needed to enhance systemic health as well as oral health. Moreover, basic biological research should be followed to support this surveyed study.

Association Serum Lipid Levels with Periodontal Disease in Korean Adults Over the Age of 50: The Korea National Health and Nutrition Examination Survey, 2016-2018

연영란,곽이섭,김혜영 한국운동생리학회 2022 운동과학 Vol.31 No.3

PURPOSE: Although the prevalence of periodontal disease in adults over the age of 50 is rapidly increasing, the association between serum lipid levels and periodontal disease in Korean adults over the age of 50 still remains to investigate. Thus, the aim was to determine the effect of serum lipid levels on periodontal disease in older adults over the age of 50 using data from the seventh Korea National Health and Nutrition Examination Survey. METHODS: The study used the data of 809 adults aged ≥50 years targeted in the 7th Korea National Health and Nutrition Examination Survey, 2016-2018. Levels of total cholesterol, triglyceride, high density- lipoprotein (HDL-cholesterol), and low density-lipoprotein (LDL-cholesterol) and periodontal conditions were measured. Complex-sample chi square test and linear regression were used to analyze the relationship serum lipid levels with periodontal disease. RESULTS: The results of chi square tests showed that the prevalence of periodontal disease among the elderly ≥50 years were statistically significant differences according to gender, age, education level, marital status, and smoking status. After adjusting for all confounding factors, HDL-cholesterol alleviated periodontal disease, while LDL-cholesterol exacerbates periodontal disease. However, total cholesterol and triglycerides were not connected with periodontal disease. CONCLUSIONS: Therefore, controlling HDL and LDL cholesterol levels through physical exercise could be a preventative measure for periodontal disease.

한국 성인의 전신건강상태와 치주질환과의 관련성

이선미,김진 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.3

The purpose of this study was to synthetically examine the relationship between systemic diseases and periodontal diseases. The data of the Fifth Korea National Health and Nutrition Examination Survey were used. SPSS 18.0 for Windows was applied for statistical analysis. The surveyed data were analyzed by using independent sample t-test for the difference between Body Mass Index and clinical test according to the existence of periodontal disease, and X2test for the relationship between periodontal disease and systemic disease. Multiple logistic regression analysis was used in order to figure out the influence upon the existence of periodontal disease prevalence among general characteristics and relevant factors to systemic disease. As results, the value of high density lipoprotein (HDL) and HBA1C were statistically significant, depending on the presence of periodontal disease. As for the relationship between periodontal disease and systemic disease, hypertension (odds ratio 1.362, p<.05), cardiovascular disease (odds ratio 2.118, p<.05), arthritis (odds ratio 1.289, p<.05) and cirrhosis (odds ratio 6.124, p<.05) were statistically significant. In conclusion, the majority of the systemic diseases such as cardiovascular system, diabetes, and liver diseases have been considered to have relationship with periodontal disease. To strengthen oral health education is needed to enhance systemic health as well as oral health. Moreover, basic biological research should be followed to support this surveyed study.

한국 성인의 전신건강상태와 치주질환과의 관련성

이선미,김진 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.3

The purpose of this study was to synthetically examine the relationship between systemic diseases and periodontal diseases. The data of the Fifth Korea National Health and Nutrition Examination Survey were used. SPSS 18.0 for Windows was applied for statistical analysis. The surveyed data were analyzed by using independent sample t-test for the difference between Body Mass Index and clinical test according to the existence of periodontal disease, and X2test for the relationship between periodontal disease and systemic disease. Multiple logistic regression analysis was used in order to figure out the influence upon the existence of periodontal disease prevalence among general characteristics and relevant factors to systemic disease. As results, the value of high density lipoprotein (HDL) and HBA1C were statistically significant, depending on the presence of periodontal disease. As for the relationship between periodontal disease and systemic disease, hypertension (odds ratio 1.362, p<.05), cardiovascular disease (odds ratio 2.118, p<.05), arthritis (odds ratio 1.289, p<.05) and cirrhosis (odds ratio 6.124, p<.05) were statistically significant. In conclusion, the majority of the systemic diseases such as cardiovascular system, diabetes, and liver diseases have been considered to have relationship with periodontal disease. To strengthen oral health education is needed to enhance systemic health as well as oral health. Moreover, basic biological research should be followed to support this surveyed study.