牙周炎是否与免疫媒介系统性疾病的风险有关?
Farid Moradi1, Erfan Shamsoddin2
1Isfahan University of Medical Sciences, Maxillofacial Surgery Department, Isfahan, Iran. Farid.moradi73@yahoo.com.
Evidence-based dentistry
|June 8, 2023
概括
牙周炎增加了长期发展全身疾病的风险,如糖尿病,类风湿性关节炎和骨质疏松症. 中度至重度的牙疾病与患糖尿病的风险更高有关,风险随严重程度增加而增加.
科学领域:
- 口腔健康和全身疾病
- 牙周病学 牙周病学
- 免疫学和自身免疫性疾病
背景情况:
- 牙周炎是一种慢性炎症性疾病,因其潜在的全身影响而越来越被认可.
- 了解与牙周炎相关的免疫介导疾病的长期风险对于公共卫生至关重要.
- 关于牙周炎与全身性疾病之间联系的现有证据需要进行全面的综合.
研究的目的:
- 与对照组相比,评估患有牙周炎的个体中免疫媒介系统性疾病的长期风险.
- 综合有关牙周炎与特定代谢性,自身免疫性和炎症性疾病之间的联系的证据.
- 调查牙周炎严重程度对这些全身性疾病发展风险的影响.
主要方法:
- 在Medline,Cochrane图书馆和EMBASE数据库进行系统的文献搜索,截至2022年6月.
- 包括同行评审的纵向研究和随机对照试验,随时跟踪至少一年.
- 用随机效应模型量化疾病风险 (RR,OR,HR) 的 27 项研究 (符合条件的 30 项) 的元分析.
主要成果:
- 牙周炎患者的糖尿病风险增加 (RR: 1.22),类风湿性关节炎 (RR: 1.27) 和骨质疏松症 (RR: 1.40).
- 对糖尿病风险观察到剂量反应关系,中度 (RR: 1.20) 和严重 (RR: 1.34) 牙周炎的风险更高.
- 敏感性分析证实了这些发现,并考虑了吸烟状况的调整.
结论:
- 中度至严重的牙周炎与患糖尿病的风险显著增加有关.
- 牙周炎严重程度对其他免疫介导疾病的影响需要进一步研究.
- 需要进行额外的高质量的研究来巩固牙周炎与多病症的关联.
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