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ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

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Confounder를 고려한 3단계의 logistic regression model을 통한 노인 인구에 있어서의 치주질환과 뇌경색 경험 유무와의 상관관계에 대한 연구

Relationship between periodontal disease and stroke history in the geriatric population

Abstract

The mean age of the population is growing older;with this aging comes the economic burden of caring for patients with age-related diseases. One of the most debilitating diseases of the elderly is cerebrovascular disease (CVD), or stroke. The World Health Organization’s (1980) definition of stroke is:“rapidly developing clinical signs of focal (at times global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin”(1). Another highly prevalent chronic disease of the elderly is periodontal disease. Based on the Third National Health and Nutrition Examination Survey (NHANES III), 53% of US adults, aged 30 to 90 years old, had 3 millimeters (mm) or more of attachment loss(2). The connection between cardiovascular disease and periodontal disease has been examined, but results have been obscure(3). For more than 10 years, this relationship has been the focus of many studies, with specific interest concentrating on the ability of dental infections to cause cardiovascular disease(4,5,6). In a meta-analysis of nine such longitudinal studies, Janket et al., concluded that there was a small but significant increase in the risk of cardiovascular disease among persons who had periodontal disease at baseline(7).While most of these studies suggest that periodontal disease was more frequent in coronary heart disease patients or ischemic stroke subjects(8,9,10,11), this finding is not universal, since other studies could not detect a statistically significant association(12,13,14,15). One of difficulty to find relationship between two diseases is that both disease share common important risk factors such as age and smoking, which could lead over adjusting as confounders in cross- sectional study(16,17). Other studies have shown that subjects with periodontal disease have elevated levels of cardiovascular risk factors, such as C-reactive protein, fibrinogen, and cholesterol(18,19,20). The relationship of periodontal disease to cardiovascular disease is further bolstered by several recent trials that have reported a decrease in systemic C-reactive protein (CRP) after periodontal treatment(21,22,23). Despite all of these studies, the association between periodontal disease and stroke remains unclear, and requires additional research until a clear consensus is reached. Few studies have been performed on large populations, with the most notable studies utilizing data from the NHANES I Follow-up Study(9,13,15,24). Since the information collected was from 1970 and was based on the Russell index with only visual examination and no periodontal probing, it may not accurately reflect the relationship of cumulative periodontal disease to stroke. In addition, no adjustment for C-reactive protein was available from NHANES I data. Hence, it is the aim of this study to use the more recent NHANES III study population to examine the association between cumulative periodontal disease and stroke history in the elderly.

keywords
뇌경색 (ischemic stroke), 치주 질환 (periodontal disease), 노인

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