Periodontal health status and lung function in two Norwegian cohorts

Rationale and objectivesThe oral cavity is united with the airways, and thus poor oral health may affect respiratory health. However, data on the interaction of periodontal and respiratory health is limited. We aimed to evaluate whether periodontal health status, assessed by the Community Periodontal Index (CPI), was related to lung function among young and middle-aged adults in two Norwegian cohorts.MethodsPeriodontal health status and lung function were measured among 656 participants in the Norwegian part of the European Community Respiratory Health Survey (ECHRS III) and the RHINESSA offspring study. Each participant was given a CPI-index from 0 to 4 where higher values reflect poorer periodontal status. The association between CPI and lung function was estimated with linear regression adjusting for age, gender, smoking, body mass index, exercise, education, use of antibiotics, inhaled medication and corrected for clustering within families.Main resultsParticipants with CPI 3–4 had significantly lower FEV1/FVC ratio compared to participants with CPI 0, b (95% CI) = -0.032 (-0.055, -0.009). Poorer periodontal health was associated with a significant decrease in the FEV1/FVC ratio with an adjusted regression coefficient for linear trend b (95% CI) = -0.009 (-0.015, -0.004) per unit increase in CPI. This negative association remained when excluding asthmatics and smokers (-0.014 (-0.022, -0,006)).ConclusionsPoorer periodontal health was associated with increasing airways obstruction in a relatively young, healthy population. The oral cavity is united with the airways and our findings indicate an opportunity to influence respiratory health by improving oral health.研究依据与目标 口腔与气道相通，因此口腔健康状况不佳可能对呼吸健康造成不良影响。然而目前关于牙周健康与呼吸健康相互作用的相关数据仍较为匮乏。本研究旨在借助社区牙周指数（Community Periodontal Index, CPI）评估牙周健康状态，探讨挪威两个队列中青年及中年人群的牙周健康状况与肺功能的相关性。 研究方法 本研究纳入欧洲社区呼吸健康调查（European Community Respiratory Health Survey, ECHRS III）挪威分支以及RHINESSA子代研究的656名参与者，对其牙周健康状况与肺功能进行了检测。所有参与者均被赋予0至4分的CPI评分，评分越高代表牙周健康状况越差。采用线性回归模型分析CPI与肺功能的相关性，校正了年龄、性别、吸烟史、体质量指数（Body Mass Index, BMI）、运动情况、受教育程度、抗生素使用情况、吸入性药物使用情况等混杂因素，并对家族聚集性进行了校正。 主要研究结果 与CPI评分为0的参与者相比，CPI评分为3~4的参与者的第1秒用力呼气容积/用力肺活量（FEV1/FVC）比值显著更低，回归系数b（95%置信区间CI）=-0.032（-0.055，-0.009）。随着CPI评分每升高1个单位，FEV1/FVC比值呈显著下降趋势，校正后的线性趋势回归系数b（95%CI）=-0.009（-0.015，-0.004）。在排除哮喘患者与吸烟者后，这一负相关关系仍然存在（b=-0.014，95%CI：-0.022，-0.006）。 研究结论 在相对年轻健康的人群中，牙周健康状况越差，气道阻塞程度越高。口腔与气道相通，本研究结果提示可通过改善口腔健康来干预呼吸健康。