牙周炎与认知功能障碍的相关性研究

doi:10.7518/hxkq.2022.05.007

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (5): 549-553.doi: 10.7518/hxkq.2022.05.007

牙周炎与认知功能障碍的相关性研究

陶玉飞¹(), 何梦娜¹, 胡红艳¹, 高子雯², 黄子昂², 李慧², 李雨晴², 李晓舒²()

^1.安徽医科大学合肥口腔临床学院，合肥市口腔医院牙周科，合肥 230031
^2.安徽医科大学第一附属医院放射科，合肥 230022

收稿日期:2022-04-03 修回日期:2022-05-03 出版日期:2022-10-01 发布日期:2022-10-17
通讯作者: 李晓舒 E-mail:www.taoyufei@163.com;lixiaoshu2016@163.com
作者简介:陶玉飞，主治医师，硕士，E-mail：www.taoyufei@163.com
基金资助:
国家自然科学基金(81901726);合肥市关键共性技术研发项目(2021YL008)

Correlation study of periodontitis with cognitive impairment

Tao Yufei¹(), He Mengna¹, Hu Hongyan¹, Gao Ziwen², Huang Ziang², Li Hui², Li Yuqing², Li Xiaoshu²()

^1.Dept. of Periodontics, Hefei Stomatological Hospital & Hefei Stomatological Clinic College, Anhui Medical University, Hefei 230031, China
^2.Dept. of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

Received:2022-04-03 Revised:2022-05-03 Online:2022-10-01 Published:2022-10-17
Contact: Li Xiaoshu E-mail:www.taoyufei@163.com;lixiaoshu2016@163.com
Supported by:
National Natural Science Foundation of China(81901726);Key Common Technology Research and Development Project of Hefei(2021YL008);Correspondence: Li Xiaoshu, E-mail: lixiaoshu2016@163.com

摘要/Abstract

摘要：

目的通过评估认知功能正常和认知功能障碍中老年人的牙周状况，来研究牙周炎与认知功能障碍之间的关系。方法选取认知功能障碍患者40例及认知功能正常的健康对照的中老年人35例，使用简易精神状态量表（MMSE）评估认知功能，并检查和评估其牙周健康状况，包括牙周炎的严重程度、余留牙齿数量、探诊出血阳性率、探诊深度（PD）以及附着水平（AL）。比较两组患者的牙周状况，分析牙周检查指标和认知功能的相关性。使用SPSS 26.0软件进行统计学分析。结果认知功能障碍组与健康对照组在牙周炎严重程度的分布情况有明显差异（χ²=13.309，P=0.001），认知功能障碍组的重度牙周炎比例显著高于健康对照组（P<0.05）。认知障碍组PD≥6 mm、AL≥5 mm的位点百分比显著高于对照组，PD=1~3 mm、AL=0~2 mm的位点百分比明显少于对照组（P<0.05）。两组的探诊出血阳性率无明显差别（P>0.05），认知功能障碍组的余留牙齿数量明显少于对照组（P<0.05）。认知功能的MMSE评分与牙齿数量、AL=0~2 mm的位点百分比呈正相关，与AL≥5 mm的位点百分比呈负相关（P<0.05）。结论牙周炎与认知功能障碍之间存在相关性，二者之间的具体关系及相关机制值得进一步探究。

关键词: 牙周炎, 认知功能障碍, 牙齿数量, 牙齿缺失, 危险因素

Abstract:

Objective This study aimed to determine the association of periodontitis with cognitive impairment by evaluating periodontal conditions in middle-aged and elderly people of normal cognition and cognitive impairment. Methods Forty patients with cognitive impairment and thirty-five healthy controls were included in this study. Mini-mental state examination (MMSE) was used to evaluate the level of cognitive function in all patients and controls. Periodontal conditions including severity of periodontitis, number of remaining teeth, percentage of bleeding on probing, probing depth (PD), and attachment level (AL) were examined. Periodontal conditions were compared between patients and controls, and the correlation between periodontal conditions and cognitive-function level was analyzed. Statistical analysis was performed with SPSS 26.0. Results The distribution of severity of periodontitis significantly differed between patients and controls (χ²=13.309 and P=0.001). The proportion of severe periodontitis in the cognitive-impairment group was significantly higher than that in the healthy controls (P<0.05). The percentage of sites with PD≥6 mm and AL≥5 mm in the cognitive-impairment group was higher than that in the controls, whereas the percentage of sites with PD=1-3 mm and AL=0-2 mm was higher in the controls (P<0.05). No significant difference in percentage of bleeding on probing was found in the two groups (P>0.05). Patients with cognitive impairment had fewer teeth than the controls (P<0.05). The level of cognitive function, assessed by MMSE, was positively correlated with the number of teeth and the percentage of sites with AL=0-2 mm, and it was negatively correlated with the percentage of sites with AL≥5 mm (P<0.05). Conclusion A correlation existed between periodontitis and cognitive impairment. Further study is essential to explore the specific relationship and related mechanism between periodontitis and cognitive impairment.

Key words: periodontitis, cognitive impairment, number of teeth, tooth loss, risk factor

中图分类号:

R 781.4

陶玉飞, 何梦娜, 胡红艳, 高子雯, 黄子昂, 李慧, 李雨晴, 李晓舒. 牙周炎与认知功能障碍的相关性研究[J]. 华西口腔医学杂志, 2022, 40(5): 549-553.

Tao Yufei, He Mengna, Hu Hongyan, Gao Ziwen, Huang Ziang, Li Hui, Li Yuqing, Li Xiaoshu. Correlation study of periodontitis with cognitive impairment[J]. West China Journal of Stomatology, 2022, 40(5): 549-553.

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参考文献 21

1	Polak D, Shapira L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes[J]. J Clin Periodontol, 2018, 45(2): 150-166.
2	Czerniuk MR, Surma S, Romańczyk M, et al. Unexpec-ted relationships: periodontal diseases: atherosclerosis-plaque destabilization? From the teeth to a coronary event[J]. Biology (Basel), 2022, 11(2): 272.
3	Lee YL, Hu HY, Chou SY, et al. Periodontal disease and preterm delivery: a nationwide population-based cohort study of Taiwan[J]. Sci Rep, 2022, 12(1): 3297.
4	Sung CE, Huang RY, Cheng WC, et al. Association between periodontitis and cognitive impairment: analysis of national health and nutrition examination survey (NHANES) Ⅲ[J]. J Clin Periodontol, 2019, 46(8): 790-798.
5	Lee CY, Chang CC, Lin CS, et al. Risk of dementia in patients with periodontitis and related protective factors: a nationwide retrospective cohort study[J]. J Clin Periodontol, 2020, 47(12): 1428-1436.
6	Dominy SS, Lynch C, Ermini F, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: evidence for disease causation and treatment with small-molecule inhibitors[J]. Sci Adv, 2019, 5(1): eaau3333.
7	Beydoun MA, Beydoun HA, Hossain S, et al. Clinical and bacterial markers of periodontitis and their association with incident all-cause and Alzheimer’s disease dementia in a large national survey[J]. J Alzheimers Dis, 2020, 75(1): 157-172.
8	Cestari JA, Fabri GM, Kalil J, et al. Oral infections and cytokine levels in patients with Alzheimer’s disease and mild cognitive impairment compared with controls[J]. J Alzheimers Dis, 2016, 52(4): 1479-1485.
9	Holmer J, Eriksdotter M, Häbel H, et al. Periodontal conditions and incident dementia: a nationwide Swedish cohort study[J]. J Periodontol, 2022. doi: 10.1002/JPER.-21-0518 .
10	Adam HS, Lakshminarayan K, Wang W, et al. The prospective association between periodontal disease and brain imaging outcomes: the Atherosclerosis Risk in Communities study[J]. J Clin Periodontol, 2022, 49(4): 322-334.
11	Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification[J]. J Clin Periodontol, 2018, 45(): S1-S8.
12	Tonetti MS, Sanz M. Implementation of the new classification of periodontal diseases: decision-making algorithms for clinical practice and education[J]. J Clin Periodontol, 2019, 46(4): 398-405.
13	Ma KS, Hasturk H, Carreras I, et al. Dementia and the risk of periodontitis: a population-based cohort study[J]. J Dent Res, 2022, 101(3): 270-277.
14	Iwasaki M, Kimura Y, Ogawa H, et al. Periodontitis, periodontal inflammation, and mild cognitive impairment: a 5-year cohort study[J]. J Periodontal Res, 2019, 54(3): 233-240.
15	Farhad SZ, Amini S, Khalilian A, et al. The effect of chronic periodontitis on serum levels of tumor necrosis factor-alpha in Alzheimer disease[J]. Dent Res J (Isfahan), 2014, 11(5): 549-552.
16	Díaz-Zúñiga J, Muñoz Y, Melgar-Rodríguez S, et al. Serotype b of Aggregatibacter actinomycetemcomitans triggers pro-inflammatory responses and amyloid beta secretion in hippocampal cells: a novel link between perio-dontitis and Alzheimer’s disease[J]. J Oral Microbiol, 2019, 11(1): 1586423.
17	Delwel S, Binnekade TT, RSGMPerez, et al. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues[J]. Clin Oral Investig, 2018, 22(1): 93-108.
18	Gil-Montoya JA, Sanchez-Lara I, Carnero-Pardo C, et al. Is periodontitis a risk factor for cognitive impairment and dementia? A case-control study[J]. J Periodontol, 2015, 86(2): 244-253.
19	Luo J, Wu B, Zhao Q, et al. Association between tooth loss and cognitive function among 3 063 Chinese older adults: a community-based study[J]. PLoS One, 2015, 10(3): e0120986.
20	Paganini-Hill A, White SC, Atchison KA. Dentition, dental health habits, and dementia: The Leisure World Cohort Study[J]. J Am Geriatr Soc, 2012, 60(8): 1556-1563.
21	Thomson WM, Barak Y. Tooth loss and dementia: a critical examination[J]. J Dent Res, 2021, 100(3): 226-231.

组别	例数	牙周炎严重程度
组别	例数	初始	中度	重度
CI组	40	4（10.0%）	15（37.5%）	21（52.5%）
HC组	35	11（31.4%）*	19（54.3%）	5（14.3%）*
χ²值	13.309
P值	0.001

牙周指标	组别	数值	t值	P值
余留牙数量/颗	CI	24.53±7.63	-3.121	0.003^※
	HC	28.40±2.70
探诊出血阳性率/%	CI	76.31±21.83	0.780	0.438
	HC	67.87±24.87
PD=1~3 mm占比/%	CI	36.29±27.82	-2.171	0.033^※
	HC	49.86±33.17
PD=4~5 mm占比/%	CI	48.29±25.43	0.133	0.895
	HC	44.88±28.61
PD≥6 mm占比/%	CI	15.45±27.48	2.043	0.046^※
	HC	5.29±10.57
AL=0~2 mm占比/%	CI	45.94±32.52	-2.596	0.011^※
	HC	62.90±30.68
AL=3~4 mm占比/%	CI	28.39±18.14	-0.844	0.401
	HC	31.19±25.57
AL≥5 mm占比/%	CI	25.61±33.09	3.163	0.002^※
	HC	5.91±14.42

牙周检查指标	MMSE
牙周检查指标	r值	P值
余留牙数量	0.293	0.011*
探诊出血阳性率	-0.167	0.563
PD=1~3 mm占比	0.167	0.151
PD=4~5 mm占比	-0.055	0.641
PD≥6 mm占比	-0.055	0.637
AL=0~2 mm占比	0.301	0.009*
AL=3~4 mm占比	0.018	0.881
AL≥5 mm占比	-0.296	0.010*

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牙周炎与认知功能障碍的相关性研究

Correlation study of periodontitis with cognitive impairment

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