80歳地域住民における歯周病と糖尿病の生命予後への影響  [in Japanese] Effects of periodontal disease and diabetes mellitus on the life prognosis in an 80-year-old community population  [in Japanese]

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Author(s)

    • 田上 綾香 Tagami Ayaka
    • 九州歯科大学大学院歯学研究科口腔保健学専攻 Department of Oral Health Sciences, Kyushu Dental University Graduate School of Dentistry
    • 園木 一男 Sonoki Kazuo
    • 九州歯科大学歯学部口腔保健学科学際教育推進ユニット Unit for Promotion of Interdisciplinary Education and Research, School of Oral Health Sciences, Kyushu Dental University
    • 秋房 住郎 Akifusa Sumio
    • 九州歯科大学歯学部口腔保健学科地域・多職種連携教育ユニット Unit of Education on Healthcare Team, School of Oral Health Sciences, Kyushu Dental University
    • 粟野 秀慈 Awano Shuji
    • 九州歯科大学歯学部歯学科総合教育学分野 Division of General Education, Kyushu Dental University
    • 角田 聡子 Kakuta Satoko
    • 九州歯科大学歯学部歯学科地域健康開発歯学分野 Division of Community Oral Health Development, Kyushu Dental University
    • 邵 仁浩 Soh Inho
    • 九州歯科大学歯学部歯学科地域健康開発歯学分野 Division of Community Oral Health Development, Kyushu Dental University
    • 岩崎 正則 Iwasaki Masanori
    • 九州歯科大学歯学部歯学科地域健康開発歯学分野 Division of Community Oral Health Development, Kyushu Dental University
    • 安細 敏弘 Ansai Toshihiro
    • 九州歯科大学歯学部歯学科地域健康開発歯学分野 Division of Community Oral Health Development, Kyushu Dental University

Abstract

<p>80歳地域住民において糖尿病と歯周病が生命予後に影響するのか検討した。平成10年福岡県北九州市とその近郊に在住する80歳697名が歯科・内科検診を受診した。697名の12年後の生存調査から,全死亡および肺炎,循環器疾患,悪性腫瘍による死亡に分けて解析を行った。4 mm以上の歯周ポケットのある歯数が0~4本を軽症歯周病群(526名,無歯顎者を含む),5本以上を重症歯周病群(169名)とした。糖尿病群は血糖値200 mg/dl以上または糖尿病の既往歴や血糖降下剤を服用している77名とした。重症歯周病群は軽症歯周病群より肺炎死リスクが12年間で2.28倍有意に高かったが,全死亡,循環器死,悪性腫瘍死には影響しなかった。糖尿病群は12年間で非糖尿病群より全死亡,肺炎死のリスクが高かった。非糖尿病+軽症歯周病群,非糖尿病+重症歯周病群,糖尿病+軽症歯周病群,糖尿病+重症歯周病群の4群では,非糖尿病+軽症歯周病群に比べ肺炎死リスクが,非糖尿病+重症歯周病群で2.90倍,糖尿病+軽症歯周病群で5.93倍,糖尿病+重症歯周病群で6.20倍と上昇した。全死亡リスクは糖尿病+軽症歯周病群で2.24倍,糖尿病+重症歯周病群で2.21倍と有意に上昇した。80歳地域高齢者では重症歯周病があると肺炎死リスクが増大するが,糖尿病を合併するとさらに肺炎死リスクが上昇する可能性が示唆された。</p>

<p>To determine whether presence of periodontal disease and diabetes mellitus influence the life prognosis in 80-year-old subjects, oral and medical examinations were conducted in 697 residents of Fukuoka Prefecture of Japan who were 80 years old in 1997, and the dates and causes of death among these residents were determined 5 years and 12 years later. We analyzed the all-cause death, pneumonia death, cardiovascular-disease death and cancer death rates between the subjects with mild periodontal disease (no. of teeth with a probing depth ≥4 mm = 0-4; n = 526) and those with severe periodontal disease (no. of teeth with a probing depth ≥4 mm ≥5; n = 169), and also between the 77 diabetic patients (history of diabetes mellitus and/or random blood sugar levels ≥200 mg/dl) and 620 non-diabetic subjects. The relative risk of pneumonia death in the severe periodontal disease group was 2.28 times higher at the 12-year follow-up as compared to that in the mild periodontal disease group. On the other hand, the relative risks of cardiovascular-disease death and cancer death were not affected by the severity of the periodontal disease. The relative risks of pneumonia death and all-cause death determined at the 12-year follow-up were higher in the diabetic patients than in the non-diabetic subjects. When we analyzed four other subject groups (mild periodontal disease+non-diabetic, mild periodontal disease+diabetic, severe periodontal disease+non-diabetic, and severe periodontal disease+diabetic), the relative risk of pneumonia death at the 12-year follow-up was 2.90 times higher in the severe periodontal disease+non-diabetic group, 5.93 times higher in the mild periodontal disease+diabetic group, and 6.20 times higher in the severe periodontal disease+diabetic group as compared to that in the mild periodontal disease+non-diabetic group. The relative risks of all-cause death in the mild periodontal disease+diabetic group and severe periodontal disease+diabetic group were 2.24 times higher and 2.21 times higher, respectively, as compared to the relative risk in the mild periodontal disease+non-diabetic group. In the 80-year-old study population, it appeared that severe periodontal disease and diabetes mellitus independently increased the risk of pneumonia death, but when diabetes mellitus was present concomitantly with severe periodontal disease, the risk of pneumonia death appeared to be further increased.</p>

Journal

  • Nihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology)

    Nihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology) 59(1), 19-27, 2017

    JAPANESE SOCIETY OF PERIODONTOLOGY

Codes

  • NII Article ID (NAID)
    130006825063
  • Text Lang
    JPN
  • ISSN
    0385-0110
  • Data Source
    J-STAGE 
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