墨玉县农村维吾尔族慢性牙周炎与白蛋白尿的相关性随访研究

摘要

Objective To investigate the association between chronic periodontitis (CP) and albuminuria for six-year follow-up in Moyu county, thereby producing scientific evidence to support strategies for the prevention and control of CP and chronic kidney disease (CKD).Methods A longitudinal,observational study was conducted in 15 villages in Moyu county.Two investigations were conducted in 2007 and 2013, respectively.All subjects received questionaire,physical examination,dental examination,and biochemical analysis.The variables analyzed included epidemiology and laboratory data.Multivariate Regression model was used to evaluate risk for albuminuria.Results The prevalence of albuminuria in the CP subjects was increased from 2.7% to 5.0% for six-year follow-up,while the percentage of eGFR<60 mL/min/1.73 m+2 increased slowly.The percentage of severe periodontitis group with albuminuria was increased from 7.9% to 11.1% during 2007 to 2013, much higher than the mild and moderate periodontitis group (3.4% vs 3.9%).After adjustment the traditional risks of albuminuria,age of 60 years or old,grade 3 hypertension and severe periodontitis are risk factors for albuminuria.The severe periodontitis was 3.6 times higher than that with albuminuria as compared with non-periodontitis group (95%CI: 1.9, 6.9).Conclusion The prevalence of severe periodontitis with albuminuria was shown to be increased in rural Uygur population, especially in severe periodontitis group.Severe periodontitis is the risk factor for albuminuria, indicating that screening for albuminuria in patients with severe periodontitis is warranted.%目的 分析墨玉县农村维吾尔族居民同一人群6年间慢性牙周炎与白蛋白尿患病率的演变情况和白蛋白尿的危险因素,为慢性牙周炎和慢性肾脏病的防治方案提供依据.方法 2007年采用多阶段分层抽样的方法从墨玉县抽取15个村中的1650名维吾尔族成人,完成慢性肾脏病等慢性疾病患病率的横断面调查,2013年对2007年资料完整的人群进行随访调查.2次调查均采用问卷调查、体格检查、口腔专科检查、实验室检查等方法进行白蛋白尿相关危险因素的分析.结果 2013年同一人群的随访结果提示牙周炎人群白蛋白尿患病率较2007年增加明显(2.7%vs5.0%),Egfr<60Ml/min/1.73m+2的比例增加较缓慢(2.6%vs3.1%).轻、中度牙周炎(3.4%vs3.9%)和重度牙周炎(7.9%vs11.1%)白蛋白尿患病率升高(P=0.000).进一步分析白蛋白尿的危险因素,校正白蛋白尿的相关危险因素后,年龄≥60岁、高血压(3级)和重度牙周炎是白蛋白尿的危险因素,其中重度牙周炎组患白蛋白尿的风险是非牙周炎组的3.6倍(95%CI:1.9~6.9).结论 墨玉县农村维吾尔族重度牙周炎人群白蛋白尿患病率有升高趋势,重度牙周炎是白蛋白尿患病的危险因素,应重视重度牙周炎患者中白蛋白尿的筛查工作.