リウマチ性関節炎患者の歯の脱落と死亡率との関連
Andi Xu1, Chunhong Zhang1, Honghua Lv1
1Department of Immunology and Rheumatology, Lishui Central Hospital and Fifth Affiliated Hospital of Wenzhou Medical University, China.
British dental journal
|August 23, 2025
まとめ
リウマチ性関節炎 (RA) の患者では,歯の脱落は死亡率の増加と関連しています. しかし,心臓血管疾患による死亡リスクは 10本以上の歯が抜けた後に減少します.
科学分野:
- リウマトロジ
- 心臓病科
- 歯科公衆衛生
背景:
- リウマチ性関節炎 (RA) は,心血管疾患 (CVD) のリスクの増加に関連する全身性自己免疫疾患です.
- 口腔の健康,特に歯の喪失は,全身の健康と関連して調査されています.
- RA患者における歯の喪失程度と死亡率の関係については,まだ完全に理解されていません.
研究 の 目的:
- リウマチ性関節炎 (RA) の患者における全因および心血管疾患による死亡率との関連を調べる.
主な方法:
- 18歳以上のRA患者に対する国家保健栄養調査 (1999年−2004年および2011−2014年) のデータを使用した.
- 詳細な口腔検査で 欠落した歯の数も確認した
- 歯の喪失に関連する死亡リスクを分析するために,コックス回帰モデルと制限された立方スラインを使用した.
主要な成果:
- 1720人のRA患者を追跡し,627人の死亡 (191人の心血管疾患) を記録した.
- 全ての原因による死亡リスクの2%の増加と相関していました
- 歯が15~28本欠けていた患者は,歯が欠けなかった患者と比較して,全因および心血管疾患による死亡リスクが著しく高かった.
- 興味深いことに,歯が10本以上欠けている患者では,心臓血管疾患による死亡リスクは,欠けている歯ごとに14%減少しました.
結論:
- RA患者における歯の喪失は全因死亡率の増加と関連しています.
- 心血管疾患による死亡リスクは 欠損歯数が10本未満のときに 増加します
- 心血管疾患による死亡リスクのパラドックスな減少は,欠落した歯の数が10個以上になると,さらに歯が失われることが観察されます.
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