Neurology:还把口腔问题不当事?小心癌症、痴呆症……找上门

2020-08-02 探索菌 生物探索

牙龈疾病尤其是牙周疾病,其影响范围远远超过我们的想象。牙周病与多种疾病相关,比如心脏病、中风、糖尿病和痴呆症等。牙龈疾病,尤其不可逆的导致牙齿脱落的疾病,可能会在20年后导致轻度认知障碍和痴呆。

都2020年了,口腔问题,你还认为是个小问题吗?事实上,牙龈疾病尤其是牙周疾病,其影响范围远远超过我们的想象。牙周病与多种疾病相关,比如心脏病、中风、糖尿病和痴呆症等。

发表在《Gut》期刊上的一项新研究中,来自美国哈佛大学T.H. Chan公共卫生学院和中山大学附属第一医院等研究机构的研究人员报告说,基于两项长期健康研究的数据(即口腔微生物组在胃癌中的作用,以及口腔细菌与食道癌的潜在联系),牙龈疾病史似乎会增加52%的胃癌和43%的食道癌风险。与没掉牙的人相比,损失两颗及以上牙齿的人患癌症风险也增加了,胃癌和咽喉癌的风险分别上升33%和42%。

在这项研究中,研究人员分析了来自护士健康研究(1992-2014)的98459名女性和来自健康专业人员随访研究(1988–2016)的49685名男性的牙周疾病史与牙齿脱落情况与食道和胃腺癌风险的关系。在22到28年的随访期间,他们记录了199例食管腺癌和238例胃腺癌。

研究结果显示,总体而言,有牙龈疾病史的人与从未有牙周疾病的相比,无论有无牙齿损失,其患喉癌的风险增加了59%。在胃癌方面则有一些不同:未掉牙的牙龈疾病患者罹患胃癌的风险增加了50%,而掉了一颗或多颗牙齿的人罹患胃癌的风险增加68%。

7月29日,美国《神经病学》(Neurology)期刊在线发表的一项研究,为牙齿卫生与痴呆症之间的联系提供了进一步证据。该研究发现,牙龈疾病,尤其是那种不可逆的导致牙齿脱落的疾病,可能会在20年后导致轻度认知障碍和痴呆。

具体来说,来自明尼阿波利斯明尼苏达大学(University of Minnesota)的Ryan T. Demmer博士及其同事招募了8,275名参与者(平均年龄为63岁)参加1996年至1998年的临床牙周检查的社区动脉粥样硬化风险研究,并在2016年之前对痴呆症的结果进行了判定。进行口腔牙周检查时,根据牙龈炎症的严重程度和程度以及附着丧失,将参与者分为牙周特征类别(PPC)。

在研究开始时,22%的人没有牙龈疾病,12%有轻度牙龈疾病,12%有严重的牙龈炎症,8%有一些牙齿脱落,12%的臼齿有疾病,11%有严重的牙齿脱落,6%有严重的牙龈疾病,还有20%完全没有牙齿。

研究人员发现,在平均18.4年的随访中,痴呆的累积发病率为19%,即共有1,569人患上了痴呆症,发病密度为每1 000人年有11.8例。与牙周健康参与者相比,患有严重PPC或无牙本质病的参与者中,发生痴呆的多变量校正风险比分别为1.22(95%置信区间,1.01至1.47)和1.21(95%置信区间,0.99至1.48)。对于轻度/中度PPC,重度PPC或无牙龈病或牙周病与牙周健康相比,痴呆/轻度认知障碍预后调整后的综合风险比为1.22(95%置信区间,1.00至1.48),1.15(95%置信区间,0.88至1.51 )和1.90(95%置信区间为1.40到2.58)。

也就是说,在研究开始时牙龈和牙齿都很健康的人群中,1826人中有264人(14%)在研究结束时患上了痴呆症。在那些有轻度牙龈疾病的人中,3,470人中有623人(18%)发展为痴呆。在患有严重牙龈疾病的参与者中,1368人中有306人(22%)患上了痴呆症。在1611人中,有376人(23%)在没有牙齿的那组中患上了痴呆症。

研究人员在观察轻度认知障碍和痴呆时发现,无牙组的患病风险大约是牙龈和牙齿健康组的两倍,患有中度或重度牙龈疾病但仍有牙齿的人,患轻度认知障碍或痴呆的风险比健康组高出20%。这些风险是在研究人员考虑了其他可能影响痴呆风险的因素后得出的,如糖尿病、高胆固醇和吸烟等。

Demmer表示,良好的口腔卫生被证明是保持牙齿和牙龈健康的终生方法。我们的研究并没有证明不健康的口腔会导致痴呆,只是表明了两者之间的联系。需要进一步的研究来证明口腔微生物和痴呆之间的联系,以及了解牙龈疾病的治疗是否可以预防痴呆。

值得注意的是,这项研究的一个局限性是,最初的牙龈检查是在参与者平均年龄63岁时进行的,而且有可能在牙龈疾病和牙齿脱落之前就已经开始了认知衰退。

总之,关于口腔问题所带来的影响的研究越来越多,我们需要真正重视起来。建议大家定期进行牙齿检查,并进行深层清洁。最重要的是要长期保护牙齿和牙龈,以保持牙周和身体健康。为了拥有更健康的口腔环境,好好刷牙吧,且刷满3分钟以上!牙线、漱口水等口腔用品都买起来。

原始出处:

Ryan T Demmer, Faye L Norby, Kamakshi Lakshminarayan, et al.Periodontal Disease and Incident Dementia: The Atherosclerosis Risk in Communities Study (ARIC).Neurology. 2020 Jul 29;10.1212/WNL.0000000000010312. doi: 10.1212/WNL.0000000000010312.

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    2020-09-24 yinhl1978
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    2020-08-02 ms5000000568257380

    口腔卫生太重要了!

    0

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    2020-08-02 junJUN

    老年人痴呆何药可用??

    0

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虽然抗PD-1/L1等免疫检查点阻断疗法已经彻底改变了癌症治疗,但只有一小部分癌症患者表现出持久的临床反应。。因此,人们对识别先前存在和获得性免疫耐药机制以及开发新的预防复发的治疗方法非常感兴趣。

Sci Adv :识别新的“氧化应激传感器” MTK1

在老龄化社会中,正在进行各种研究以探索活性氧与与衰老相关的疾病(如癌症),慢性炎性疾病和代谢综合症之间的关系。本研究发现了一种新的机制,该机制通过检测人体中的氧化应激来引发细胞反应。

癌症为什么会复发?为什么会转移?

随着科学的发展,癌症的治疗方法在不断更新,一定程度上改善了癌症患者的生存率。比如:各种外科手术的更新、多学科护理、化疗药物的改善、靶向生物制剂的引入,并且出现了“分子靶向药物”