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Wang D, Dai L, Cui Z, Xing W, Huang X, Yang H, Shan Y. Association between periodontal diseases and chronic obstructive pulmonary disease: Evidence from sequential cross-sectional and prospective cohort studies based on UK Biobank. J Clin Periodontol 2024; 51:97-107. [PMID: 37850252 DOI: 10.1111/jcpe.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
AIM To investigate the association between periodontal diseases, airflow limitation and incident chronic obstructive pulmonary disease (COPD) in a large-scale prospective UK Biobank cohort. MATERIALS AND METHODS Our approach comprised a cross-sectional study and a prospective cohort. Periodontal diseases were determined based on the participants' self-reported dental symptoms, including painful gums, bleeding gums and loose teeth. Logistic regression and Cox proportional hazards models were used to evaluate the association of periodontal diseases with airflow limitation and incident COPD in the cross-sectional study and the prospective cohort, respectively. RESULTS The cross-sectional study involved 495,610 participants. Multivariable analysis found that periodontal diseases were significantly associated with airflow limitation (odds ratio = 1.036, 95% confidence interval [CI]: 1.015-1.059). The cohort study included 379,266 participants with a median follow-up period of 12.68 years. An elevated risk of incident COPD was associated with the presence of periodontal diseases (hazard ratio: 1.248, 95% CI: 1.174-1.326). The effect was consistent among subgroups, including baseline age (≤65 or >65 years), sex, smoking status and diabetes mellitus. CONCLUSIONS Periodontal diseases are associated with airflow limitation and elevated COPD incidence. Maintaining good periodontal health in patients with chronic bronchitis and emphysema may help prevent the onset of COPD.
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Affiliation(s)
- Dongyun Wang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Liang Dai
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhengqian Cui
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Weili Xing
- Internal Medicine, Distinct Health Care, Guangzhou, China
| | - Xiaoyan Huang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hongyu Yang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Ying Shan
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
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Røsland A, Bertelsen RJ, Bunaes DF, Drengenes C, Engström G, Klinge B, Lie SA, Nilsson PM, Jönsson D, Malinovschi A. Periodontitis is associated with airflow obstruction in the Malmö Offspring Dental Study. J Clin Periodontol 2024; 51:86-96. [PMID: 37837290 DOI: 10.1111/jcpe.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 08/31/2023] [Accepted: 09/16/2023] [Indexed: 10/15/2023]
Abstract
AIM To investigate the association between periodontitis and lung function in the Malmö Offspring Dental Study. MATERIALS AND METHODS In all 1001 individuals (49.9% female, mean age: 44.6) from Malmö Offspring Dental Study were included. Periodontitis was assessed by a full-mouth examination protocol including bleeding on probing and classified according to the American Academy of Periodontology/Center for Disease Control definitions. Forced expiratory volume in 1 s (FEV1 ) and forced vital capacity (FVC) were expressed as absolute values and %predicted according to Global Lung Function Initiative reference values. FEV1 , FVC and FEV1 /FVC were analysed in relation to periodontal status using linear regression. RESULTS Severe periodontitis was found in 7% of the population. Adjusted regression models showed significant associations between lung function and severe periodontitis with 2.1 unit lower FEV1 /FVC ratio (95% CI: -3.91, -0.23) and odds ratio (adjusted) of 2.56 (95% CI: 1.40, 4.75, p = .003) for airflow obstruction (FEV1 /FVC less than the lower limit of normal) if having severe periodontitis. Lower values of %predicted FEV1 and %predicted FVC, but not FEV1 /FVC, were found in individuals with >25% bleeding on probing. CONCLUSIONS Severe periodontitis was associated with lower FEV1 /FVC ratio and airflow obstruction in the present cohort. More large-scale prospective studies and intervention studies are required for a comprehensive evaluation.
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Affiliation(s)
- Anders Røsland
- Department of Clinical Dentistry, Section of Periodontics, University of Bergen, Bergen, Norway
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Dagmar F Bunaes
- Department of Clinical Dentistry, Section of Periodontics, University of Bergen, Bergen, Norway
| | | | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Bjørn Klinge
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | - Stein-Atle Lie
- Department of Clinical Dentistry, Section of Periodontics, University of Bergen, Bergen, Norway
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Daniel Jönsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Public Dental Service of Skåne, Lund, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
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Lin P, Liu A, Tsuchiya Y, Noritake K, Ohsugi Y, Toyoshima K, Tsukahara Y, Shiba T, Nitta H, Aoki A, Iwata T, Katagiri S. Association between periodontal disease and chronic obstructive pulmonary disease. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:389-402. [PMID: 38022389 PMCID: PMC10652094 DOI: 10.1016/j.jdsr.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) and periodontal disease are chronic inflammatory conditions that significantly affect an individual's overall health and well-being. Generally, the prevalence of periodontitis is higher in patients with COPD than those without COPD, which may partly be attributed to common risk factors in COPD, such as smoking, respiratory infections, and inflammation. In particular, periodontitis may exacerbate the progression of COPD and further deteriorate the respiratory system by promoting inflammatory responses and bacterial infections. Immunocytes, including neutrophils, and microorganisms such as Fusobacterium nucleatum originating from oral biofilms are believed to be crucial factors influencing to COPD. Furthermore, the potential benefits of treating periodontal disease in COPD outcomes have been investigated. Although the relationship between COPD and periodontal disease has been preliminarily studied, there is currently a lack of large-scale clinical studies to validate this association. In addition to clinical examinations, investigating biomarkers and microbiology may contribute to explore the underlying mechanisms involved in the management of these conditions. This review aims to contribute to a better understanding of the clinical and basic research aspects of COPD and periodontitis, allowing for potential therapeutic approaches and interdisciplinary management strategies.
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Affiliation(s)
- Peiya Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Anhao Liu
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yosuke Tsuchiya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry, Division of Clinical Dentistry, Tokyo Medical and Dental University Hospital, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keita Toyoshima
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuta Tsukahara
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Hiroshi Nitta
- Department of General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Tamiya H, Mitani A, Abe M, Nagase T. Putative Bidirectionality of Chronic Obstructive Pulmonary Disease and Periodontal Disease: A Review of the Literature. J Clin Med 2023; 12:5935. [PMID: 37762876 PMCID: PMC10531527 DOI: 10.3390/jcm12185935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/24/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide and is currently the third leading cause of death globally. The long-term inhalation of toxic substances, mainly cigarette smoke, deteriorates pulmonary function over time, resulting in the development of COPD in adulthood. Periodontal disease is an inflammatory condition that affects most adults and is caused by the bacteria within dental plaque. These bacteria dissolve the gums around the teeth and the bone that supports them, ultimately leading to tooth loss. Periodontal disease and COPD share common risk factors, such as aging and smoking. Other similarities include local chronic inflammation and links with the onset and progression of systemic diseases such as ischemic heart disease and diabetes mellitus. Understanding whether interventions for periodontal disease improve the disease trajectory of COPD (and vice versa) is important, given our rapidly aging society. This review focuses on the putative relationship between COPD and periodontal disease while exploring current evidence and future research directions.
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Affiliation(s)
- Hiroyuki Tamiya
- Division for Health Service Promotion, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akihisa Mitani
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masanobu Abe
- Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Takahide Nagase
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Yang M, Peng R, Li X, Peng J, Liu L, Chen L. Association between chronic obstructive pulmonary disease and periodontal disease: a systematic review and meta-analysis. BMJ Open 2023; 13:e067432. [PMID: 37369414 PMCID: PMC10410961 DOI: 10.1136/bmjopen-2022-067432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives Studies have suggested contradictory results on the relationship between chronic obstructive pulmonary disease (COPD) and periodontal disease (PD). The aim of this study was to determine whether PD increased the risk of COPD and COPD-related clinical events. Design A systematic review and meta-analysis. Data sources PubMed, Ovid EMBASE and Ovid CENTRAL were searched from inception to 22 February 2023. Eligibility criteria for studies We included trials and observational studies evaluating association of PD with the risk of COPD or COPD-related events (exacerbation and mortality), with statistical adjustment for smoking. Data extraction and synthesis Two investigators independently extracted data from selected studies using a standardised Excel file. Quality of studies was evaluated using the Newcastle-Ottawa Scale. OR with 95% CI was pooled in a random-effect model with inverse variance method. Results 22 observational studies with 51 704 participants were included. Pooled analysis of 18 studies suggested that PD was weakly associated with the risk of COPD (OR: 1.20, 95% CI 1.09 to 1.32). However, in stratified and subgroup analyses, with strict adjustment for smoking, PD no longer related to the risk of COPD (adjusting for smoking intensity: OR: 1.14, 95% CI 0.86 to 1.51; smokers only: OR: 1.46, 95% CI 0.92 to 2.31; never smokers only: OR: 0.93, 95% CI 0.72 to 1.21). Moreover, PD did not increase the risk of COPD-related exacerbation or mortality (OR: 1.18, 95% CI 0.71 to 1.97) in the pooled result of four studies. Conclusions This study demonstrates PD confers no risk for COPD and COPD-related events when strictly adjusted by smoking. Large-scale prospective cohort studies with control of potential confounding factors are warranted to validate the present findings.
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Affiliation(s)
- Mei Yang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ran Peng
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, 363 Hospital, Chengdu, Sichuan, China
| | - Xiaoou Li
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junjie Peng
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine, 363 Hospital, Chengdu, Sichuan, China
| | - Lei Chen
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Liu Z, Zhou X, Liang L, Han X, Yang T, Huang K, Lin Y, Wang Z, Wang C. Association between symptoms of severe periodontitis and post-bronchodilator lung function: results from the China pulmonary health study. BMC Pulm Med 2023; 23:214. [PMID: 37330486 DOI: 10.1186/s12890-023-02485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/17/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND The association between periodontitis and post-bronchodilator lung function is unclear. We aimed to determine the associations between symptoms of severe periodontitis (SSP) and post-bronchodilator lung function in the Chinese population. METHODS A cross-sectional study (China Pulmonary Health study) was conducted from 2012 to 2015 in a large Chinese nationally representative sample of 49,202 participants aged 20-89 years. Data on demographic characteristics and periodontal symptoms of participants were collected by questionnaire. Participants who had at least one of the two severe symptoms (tooth mobility and natural tooth loss) in the past year were defined to have SSP, which was set as one variable for analyses. Post-bronchodilator lung function data including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were collected by spirometry. RESULTS The values of post-FEV1, post-FVC and post-FEV1/FVC of the participants with SSP were all significantly lower than the participants without SSP (all p < 0.001). SSP were significantly associated with post-FEV1/FVC < 0.7 (p < 0.001). In the multiple regression analyses, SSP were still negatively associated with post-FEV1(b = -0.04, 95%CI (-0.05 -0.03), p < 0.001), post-FEV1/FVC (b = -0.45, 95%CI (-0.63, -0.28), p < 0.001) and significantly associated with post-FEV1/FVC < 0.7 (OR = 1.08, 95%CI 1.01-1.16, p = 0.03) after full adjustment for potential confounders. CONCLUSIONS Our data suggest that SSP were negatively associated with post-bronchodilator lung function in the Chinese population. Longitudinal cohort studies are needed to confirm these associations in the future.
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Affiliation(s)
- Zhiqiang Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Xuan Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Lirong Liang
- Department of Clinical Epidemiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Respiratory Medicine, Beijing, China
| | - Xiaozhe Han
- Department of Oral Science and Translational Research, Nova Southeastern University College of Dental Medicine, Florida, USA
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2 Yinghuayuan Dongjie, Chaoyang District, Beijing, 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Peking Union Medical College, Beijing, China
- Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Kewu Huang
- Beijing Institute of Respiratory Medicine, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Beijing, China
| | - Yingxiang Lin
- Beijing Institute of Respiratory Medicine, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Beijing, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China.
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2 Yinghuayuan Dongjie, Chaoyang District, Beijing, 100029, China.
- National Clinical Research Center for Respiratory Diseases, Beijing, China.
- Institute of Respiratory Medicine, Peking Union Medical College, Beijing, China.
- Department of Respiratory Medicine, Capital Medical University, Beijing, China.
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.
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7
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Molina A, Huck O, Herrera D, Montero E. The association between respiratory diseases and periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:842-887. [PMID: 36606394 DOI: 10.1111/jcpe.13767] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
AIM To evaluate (1) whether periodontitis has an influence on the prevalence/incidence of respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma, community-acquired pneumonia [CAP], obstructive sleep apnoea [OSA] and COVID-19), and (2) what is the impact of periodontal therapy on the onset or progression of respiratory diseases. MATERIALS AND METHODS An electronic search was performed on Pubmed, Cochrane Library and Scopus databases up to October 2021, to identify studies answering the PECOS and PICOS questions. RESULTS Seventy-five articles were selected. Meta-analyses identified statistically significant associations of periodontitis with COPD (nstudies = 12, odds ratio [OR] = 1.28, 95% confidence interval [CI] [1.16; 1.42], p < .001), and OSA (ns = 6, OR = 1.65, 95% CI [1.21; 2.25], p = .001), but not for asthma (ns = 9, OR = 1.53, 95% CI [0.82; 2.86], p = .181). For acute conditions, two studies were found for CAP, while for COVID-19, significant associations were found for the need of assisted ventilation (ns = 2, OR = 6.24, 95% CI [2.78; 13.99], p < .001) and COVID-related mortality (ns = 3, OR = 2.26, 95% CI [1.36, 3.77], p = .002). Only four intervention studies were found, showing positive effects of periodontal treatment on COPD, asthma and CAP. CONCLUSIONS A positive association between periodontitis and COPD, OSA and COVID-19 complications has been found, while there is a lack of intervention studies.
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Affiliation(s)
- Ana Molina
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Olivier Huck
- Dental Faculty Robert Franck, Université de Strasbourg, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Strasbourg, France
| | - David Herrera
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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The role of Th17 cells: explanation of relationship between periodontitis and COPD? Inflamm Res 2022; 71:1011-1024. [PMID: 35781342 DOI: 10.1007/s00011-022-01602-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/13/2022] [Indexed: 11/05/2022] Open
Abstract
Periodontitis and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases with common risk factors, such as long-term smoking, age, and social deprivation. Many observational studies have shown that periodontitis and COPD are correlated. Moreover, they share a common pathophysiological process involving local accumulation of inflammatory cells and cytokines and damage of soft tissues. The T helper 17 (Th17) cells and the related cytokines, interleukin (IL)-17, IL-22, IL-1β, IL-6, IL-23, and transforming growth factor (TGF)-β, play a crucial regulatory role during the pathophysiological process. This paper reviewed the essential roles of Th17 lineage in the occurrence of periodontitis and COPD. The gaps in the study of their common pathological mechanism were also evaluated to explore future research directions. Therefore, this review can provide study direction for the association between periodontitis and COPD and new ideas for the clinical diagnosis and treatment of the two diseases.
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Nan Z, Bata W, Zhanpeng Z, Chen X, Yue H, Qihui L, Zhang H. Response to comment on "Occurrence of neonicotinoid insecticides and their metabolites in tooth samples collected from south China: Associations with periodontitis". CHEMOSPHERE 2022; 291:132804. [PMID: 34800512 DOI: 10.1016/j.chemosphere.2021.132804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Zhang Nan
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Wang Bata
- Department of Orthopedics, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Zhang Zhanpeng
- Department of Dermatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Xufeng Chen
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Huang Yue
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Liu Qihui
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, PR China.
| | - Hua Zhang
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, PR China.
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10
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Qi J, Liu E, Guo YF, Hu JM, Liu YT, Chen G, Yue HQ. Association between periodontal disease and osteoporosis in postmenopausal women: a protocol for systematic review and meta-analysis. BMJ Open 2021; 11:e049277. [PMID: 34518261 PMCID: PMC8438846 DOI: 10.1136/bmjopen-2021-049277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Periodontal disease and osteoporosis are common chronic diseases, especially for the postmenopausal women. Several original studies explore the association, but there still controversial. Therefore, we will conduct this systematic review and meta-analysis to assess the association between periodontal disease and osteoporosis in postmenopausal women. METHODS AND ANALYSIS This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols. We will systematically search Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and Scopus from inception to August 2021 to collect all relevant publications, with no restrictions on publication date or languages. Study selection, data extraction and risk of bias assessment will be conducted independently by two trained reviewers independently. The Cochrane's tool for assessing risk of bias, Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality will be used for the risk of bias assessment. OR, HR and risk ratio with 95% CI were considered as the effect size for dichotomous outcomes, weighted mean difference with 95% CI were calculated as the effect size for continuous outcomes. Random-effects models will be used. Heterogeneity between studies will be assessed via the forest plot and I². Publication bias will detected by funnel plots, Begg's test and Egger's test. The subgroup analyses and sensitivity ananlyses will also be used to explore and interpret the heterogeneity. ETHICS AND DISSEMINATION This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021225746.
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Affiliation(s)
- Jing Qi
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - E Liu
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yu-Feng Guo
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Jie-Mei Hu
- Bone density test room of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yu-Ting Liu
- Radiology of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Guang Chen
- Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, Gansu, China
| | - Hai-Quan Yue
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
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11
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Zhang N, Wang B, Zhang Z, Chen X, Huang Y, Liu Q, Zhang H. Occurrence of neonicotinoid insecticides and their metabolites in tooth samples collected from south China: Associations with periodontitis. CHEMOSPHERE 2021; 264:128498. [PMID: 33032210 DOI: 10.1016/j.chemosphere.2020.128498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
Neonicotinoid insecticides (NEOs) are widely used in agricultural production processes in China and worldwide. NEOs have been an increasing concern because of their potential toxicity to nontarget organisms. However, studies that focused on human exposure to NEOs in China are limited. In this study, levels of six parent NEOs (p-NEOs), namely imidacloprid (IMI), acetamiprid (ACE), clothianidin (CLO), dinotefuran (DIN), thiamethoxam (THIX), and thiacloprid (THI), and three metabolites (m-NEOs), such as 5-hydroxy-imidacloprid (5-OH-IMI), 1-methyl-3-(tetrahydro-3-furyl methyl) urea (UF), and N-desmethyl-acetamiprid (N-dm-ACE) were measured in 127 tooth samples collected from South China. P-NEOs and m-NEOs are frequently detected (76%-93%) in tooth samples, with median levels of 0.03-1.20 ng/g. UF is the most abundant NEOs in tooth samples (36%). Females have higher NEO levels than males, and gender-related differences in NEO levels are found. Associations among most p-NEOs are also found (p < 0.05), indicating the source of human exposure to p-NEOs is related. However, no significant relationships (p > 0.05) between levels of m-NEOs and their corresponding p-NEOs are found, suggesting that exogenous m-NEOs contribute to exposure. We have also examined the associations between human NEOs exposure and periodontitis, and associations between NEO exposure and periodontitis are observed (OR = 2.63-7.33; 95% CI = 1.01-21.1, p-trend < 0.05). Our results suggest that NEO levels are associated with increased odds of prevalent periodontitis. This study is the first to report about p-NEOs and m-NEOs in tooth samples collected from South China.
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Affiliation(s)
- Nan Zhang
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Bata Wang
- Department of Orthopedics, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Zhanpeng Zhang
- Department of Dermatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Xufeng Chen
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Yue Huang
- Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou, 510632, PR China
| | - Qihui Liu
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, PR China.
| | - Hua Zhang
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, PR China.
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Ghassib IH, Batarseh FA, Wang HL, Borgnakke WS. Clustering by periodontitis-associated factors: A novel application to NHANES data. J Periodontol 2021; 92:1136-1150. [PMID: 33315260 DOI: 10.1002/jper.20-0489] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/28/2020] [Accepted: 12/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Unsupervised clustering is a method used to identify heterogeneity among groups and homogeneity within a group of patients. Without a prespecified outcome entry, the resulting model deciphers patterns that may not be disclosed using traditional methods. This is the first time such clustering analysis is applied in identifying unique subgroups at high risk for periodontitis in National Health and Nutrition Examination Surveys (NHANES 2009 to 2014 data sets using >500 variables. METHODS Questionnaire, examination, and laboratory data (33 tables) for >1,000 variables were merged from 14,072 respondents who underwent clinical periodontal examination. Participants with ≥6 teeth and available data for all selected categories were included (N = 1,222). Data wrangling produced 519 variables. k-means/modes clustering (k = 2:14) was deployed. The optimal k-value was determined through the elbow method, formula = ∑ (xi 2 ) - ((∑ xi )2 /n). The 5-cluster model showing the highest variability (63.08%) was selected. The 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (AAP) and 2018 European Federation of Periodontology/AAP periodontitis case definitions were applied. RESULTS Cluster 1 (n = 249) showed the highest prevalence of severe periodontitis (43%); 39% self-reported "fair" general health; 55% had household income <$35,000/year; and 48% were current smokers. Cluster 2 (n = 154) had one participant with periodontitis. Cluster 3 (n = 242) represented the greatest prevalence of moderate periodontitis (53%). In Cluster 4 (n = 35) only one participant had no periodontitis. Cluster 5 (n = 542) was the systemically healthiest with 77% having no/mild periodontitis. CONCLUSION Clustering of NHANES demographic, systemic health, and socioeconomic data effectively identifies characteristics that are statistically significantly related to periodontitis status and hence detects subpopulations at high risk for periodontitis without costly clinical examinations.
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Affiliation(s)
- Iya H Ghassib
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | | | - Hom-Lay Wang
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | - Wenche S Borgnakke
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
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