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.

한국 성인의 비타민 D와 치주질환의 관계

김재민,황희진 한국치위생과학회 2018 치위생과학회지 Vol.18 No.4

Periodontal disease is a chronic inflammatory disease that affects quality of life and nutrition. Several studies have demonstrated a link between periodontal disease and low bone density, and vitamin D is expected to have a beneficial effect on periodontal disease as well as on bone mineral density and anti-inflammatory effects. The purpose of this study was to identify the association between periodontal disease and vitamin D because the results are different in some studies and there is a lack of research in Korea. In this study, we conducted a multiple linear regression analysis of 8,783 subjects among 23,626 subjects who were older than 20 years of age, who had serum vitamin D levels and periodontal disease, who had three years of the National Health and Nutrition Survey that was conducted in Korea from 2012 to 2014. We examined the relationship between serum vitamin D levels and periodontal disease. Tooth loss and vitamin D levels were negatively correlated (=−0.028, p=0.008). In addition, the prevalence of periodontal disease was found to be higher in men younger than 50 years of age with lower vitamin D levels (Q1: 1.769 [1.125∼ 2.782], Q2: 1.182 [0.743∼1.881], Q3: 0.676 [0.400∼1.881]; p=0.001). Low vitamin D levels and periodontal disease are common diseases in primary care. Vitamin D supplementation is expected to have favorable effect on periodontal disease and falls, osteoporosis, osteoarthritis, and cancer. Therefore, patients with periodontal disease may benefit from periodic vitamin D management to improve quality of life as well as to manage periodontal disease. In addition, as shown in this study, not only elderly individuals, but also men younger than 50 years of age are related to periodontal disease, so there should be interest in controlling the levels of vitamin D in adults. 치주질환은 광범위한 만성 염증질환으로 삶의 질, 영양섭취에 큰 영향을 준다. 몇몇의 연구에서 치주질환과 골밀도가 낮은 사람과의 연관성이 보고되고 있으며 비타민 D는골밀도뿐 아니라 항염증효과도 있기 때문에 치주질환에도 좋은 영향을 줄 것으로 예측된다. 하지만 연구에 따라 다른결과를 보이고 한국에서는 이에 대한 연구가 부족하므로, 한국인에서 비타민 D와 치주질환의 관계를 알아보기 위하여 본 연구를 시행하였다. 본 연구는 대한민국에서 실시한국민건강영양조사 2012∼2014년의 3개년도 23,626명 중20세 이상, 비타민 D 혈중농도, 치주질환의 유무가 있는8,783명을 대상으로 다중선형회귀분석을 시행하여 연령별, 성별 비타민 D 혈중농도와 치주질환이 관계가 있는지 살펴보았다. 치아 상실과 비타민 D의 농도는 음의 상관관계를가졌다(=−0.028, p=0.008). 또한 대상군 중 50세 이하의남성에서 비타민 D의 농도가 낮을수록 치주질환의 유병률이 높은 것으로 나타났다(Q1: 1.769 [1.125∼2.782], Q2: 1.182 [0.743∼1.881], Q3: 0.676 [0.400∼1.881]; p=0.001). 비타민 D의 결핍과 치주질환은 진료현장에서 흔히 볼 수 있는 질환이다. 비타민 D의 보충으로 치주질환 및 낙상, 골다공증, 골관절염, 암 등에서 좋은 영향을 미칠 것으로 기대되므로 치주질환이 있는 환자에게는 치주질환의 관리뿐만 아니라 삶의 질 향상을 위해 비타민 D 농도의 일정수준 유지가 도움이 될 수 있겠다. 따라서 본 연구에서와 같이 노인뿐만 아니라 50세 이하 성인남성에서도 연관이 있으므로, 성인에서도 비타민 D 농도의 일정수준 유지에 관심을 가져야할 것이다.

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.

타액 프로테오믹스를 이용한 치주질환의 진단표지자 검색

김현철,김형섭,문경숙,조남표 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.

The prevalence of periodontal disease according to oral care habits

( Do-hee Kim ),( Hyun-ju Chung ),( Ok-su Kim ) 조선대학교 구강생물학연구소 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.

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.

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

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.