慢性牙周炎与高脂血症相关性的Meta分析

doi:10.7518/hxkq.2017.04.015

摘要/Abstract

摘要：

目的采用系统评价的方法评价慢性牙周炎与高脂血症相关性。方法计算机检索PubMed、Cochrane Library、Embase、中国生物医学文献数据库、中国期刊全文数据库、万方和维普数据库,检索时限从建库到2016年7月,限中、英文,由两位研究者按标准纳入牙周炎与高脂血症相关性的观察性研究论文,进行资料提取及质量评价,采用RevMan 5.3软件进行Meta分析并用GRADE 3.6软件进行证据整体质量等级的评定。结果一共纳入6个病例对照研究和1个队列研究。Meta分析结果显示,慢性牙周炎患者血清中甘油三酯（TG）的浓度明显高于牙周健康组（MD=50.50,95%可信区间=39.57~61.42,P<0.000 01）,血清总胆固醇（TC）浓度也较牙周健康组明显增（MD=17.54,95%可信区间=10.91~24.18,P<0.000 01）;并且牙周炎患者血清中TG与TC升高的风险分别是牙周健康者的4.73倍（OR=4.73,95%可信区间=2.74~8.17,P<0.000 01）和3.62倍（OR=3.62,95%可信区间=2.18~6.03,P<0.000 01）;而两组在高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的统计学差异不大。结论现有证据表明慢性牙周炎与高脂血症是存在相关性的,慢性牙周炎是高脂血症的一个独立危险因素,尤其是对血清中的TC和TG有显著影响。

关键词: 慢性牙周炎, 高脂血症, 危险因素, Meta分析

Abstract:

Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence.Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cho-lesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipo-protein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

Key words: chronic periodontitis, hyperlipidemia, risk factors, Meta-analysis

中图分类号:

R781.4

杨镰徽, 连梅菲, 胡钟月, 冯云枝. 慢性牙周炎与高脂血症相关性的Meta分析[J]. 华西口腔医学杂志, 2017, 35(4): 419-426.

Lianhui Yang, Meifei Lian, Zhongyue Hu, Yunzhi Feng. Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies[J]. West China Journal of Stomatology, 2017, 35(4): 419-426.

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文献	国家	研究类型	样本量（牙	人群	年龄/岁	牙周炎	校正因素	结局指标	NOS
文献	国家	研究类型	周炎/健康）	来源	年龄/岁	分级	校正因素	结局指标	分数
Moeintaghavi等^[5]	伊朗	病例对照	40/40	医院	牙周炎组32.32±9.2;	中、重度	年龄,性别,其他	TC,TG,HDL,	6
					健康组31.4±7.6		相关系统疾病	LDL
Zhou等^[8]	中国	病例对照	40/20	医院	>40	中、重度	年龄,其他相关的	TC,TG,HDL,	7
							系统病	LDL,PI,BOP,
								PPD, CAL
Cutler等^[10]	朝鲜	病例对照	26/25	牙学院	>25	重度	年龄,性别,种族	TC,TG,血清	8
								IgG,LPS的反应
Lösche等^[11]	德国	病例对照	39/40	医院	牙周炎组54.8±3.1;	中、重度	年龄,性别,吸烟	TC,TG,HDL,	7
					正常组55.4±2.8		史	LDL,血糖
Machado等^[12]	巴西	病例对照	30/30	医院	>20	中、重度	年龄,性别,其他	年龄,BMI,TC,	7
							相关系统疾病	TG,HDL,LDL,
								血糖,牙缺失
Golpasand Hagh等^[21]	伊朗	病例对照	45/45	医院	牙周炎组34.11±4.71;	未明确	年龄,性别	TC,TG,HDL,	7
					健康组35.36±5.05			LDL,血糖
Taleghani等^[22]	伊朗	队列研究	26/26	医院	牙周炎组45±12.2;	中、重度	年龄,BMI,性	TC,TG,HDL,	4
					正常组48±11.6		别,日常活动率,	LDL
							吸烟饮食,家族血
							脂水平