Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey
2010年06月01日

文献：de Oliveira C et al. Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey. BMJ. 2010;340:c2451

平均50歳の一般集団11869名を対象に、口腔衛生と心血管疾患および炎症マーカー・血液凝固因子の関連を調査。口腔衛生不良の対象者で、心血管疾患イベントリスクの上昇が見られ（ハザード比1.7）、C反応性蛋白・フィブリノーゲンの濃度も上昇していた。著者らは、この因果関係についてさらなる検討が必要と指摘している。

Cesar de Oliveira, research fellow in epidemiology and public health, Richard Watt, professor and honorary consultant in dental public health, Mark Hamer, senior research fellow in epidemiology and public health

1 Department of Epidemiology and Public Health, University College London, London WC1E 6BT

Correspondence to: R Watt r.watt@ucl.ac.uk

Objective To examine if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).

Design National population based survey.

Setting Scottish Health Survey, which draws a nationally representative sample of the general population living in households in Scotland.

Participants 11 869 men and women, mean age 50 (SD 11).

Main outcome measures Oral hygiene assessed from self reported frequency of toothbrushing. Surveys were linked prospectively to clinical hospital records, and Cox proportional hazards models were used to estimate the risk of cardiovascular disease events or death according to oral hygiene. The association between oral hygiene and inflammatory markers and coagulation was examined in a subsample of participants (n=4830) by using general linear models with adjustments.

Results There were a total of 555 cardiovascular disease events over an average of 8.1 (SD 3.4) years of follow-up, of which 170 were fatal. In about 74% (411) of cardiovascular disease events the principal diagnosis was coronary heart disease. Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7, 95% confidence interval 1.3 to 2.3; P<0.001) in a fully adjusted model. They also had increased concentrations of both C reactive protein (β 0.04, 0.01 to 0.08) and fibrinogen (0.08, -0.01 to 0.18).

Conclusions Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.

c de Oliveira et al 2010
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2010.6.1　記事提供：m3.com