The association between periodontitis and systemic disease among Korean adults

Younghee Kim

doi:10.11149/jkaoh.2016.40.4.244

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Kim: The association between periodontitis and systemic disease among Korean adults

Original Article

J Korean Acad Oral Health 2016;40(4):244-249.

Published online: 15 December 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.4.244

The association between periodontitis and systemic disease among Korean adults

Younghee Kim

Department of Dental Hygiene, Kyungdong University, Wonju, Korea

Corresponding Author: Younghee Kim Department of Dental Hygiene, Kyungdong University, 815 Gyeonhwon-ro, Munmak-eup, Wonju 26495, Korea Tel: +82-33-738-1308 Fax: +82-33-738-1349 E-mail: kyh1225@snu.ac.kr

Received 20 October 2016 Revised 25 November 2016 Accepted 1 December 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Periodontal disease has developed not only as a localized factor of oral disease, but also as an important factor related to diabetes, cardiovascular disease, hypertension, and smoking. The aim of this study was to investigate the association between periodontitis and systemic disease by utilizing the representative national health nutrition survey in Korea.

Methods

Study participants without any missing data were selected from the sixth (2014) national health nutrition survey, which included 5,604 individuals with periodontal pocket depth. To determine that periodontal disease was associated not only with localized factors but with various factors interacting with each other, parameters such as hypertension, diabetes, heart disease, dyslipidemia, alcohol intake, smoking, age, level of education, income, regular visits to a dentist, frequency of toothbrushing, and presence of a dental cavity were investigated and evaluated anemic factors with CPITN. The associations were analyzed using the chi-square test and multiple logistic regression.

Results

Only hypertension was found to influence periodontitis independently [95% confidence interval: 0.6-0.9].

Conclusions

A statistically significant association between hypertension and periodontal disease was noted and this association is expected to be fundamental data for future studies.

Keywords: Periodontitis, Risk factors, Systemic disease

References

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Table 1.

Sociodemographic characteristics

	Variable	N(Total 5,604)	%
Gender	Male	2,350	49.5
	Female	3,254	50.5
Age	20-29	565	17.0
	30-39	965	19.5
	40-49	981	21.3
	50-59	1,082	19.9
	60-69	974	11.5
	≥70	1,037	10.9
Education	Lower middle school	1,754	26.3
	High school	1,580	37.1
	College	1,589	36.6
Income	Low	1,381	25.5
	Moderate-low	1,406	25.1
	Moderate-High	1,407	24.6
	High	1,380	24.9
Smoking	No	4,139	76.3
	Yes	985	23.7
Alcohol drinking	No	672	10.1
	Yes	4,460	89.9

The data were analysed by reflecting complex weighted sample design.

Table 2.

Systemic disease of study subject

Variable		N	%
Hypertension	No	3,825	83.2
	Yes	1,149	16.8
Diabetes mellitus	No	4,528	93.4
	Yes	441	6.6
Cardiac disease	No	4,847	98.3
	Yes	123	1.7
Dyslipidemia	No	4,268	89.0
	Yes	705	11.0
Anemia	No	4,552	93.7
	Yes	377	6.3

Table 3.

Oral health status and behavior of the subjects according to Anemia

Variable		Anemia		P-value
Variable		No	Yes	P-value
Daily tooth brushing>2 times		3,766 (90.4)	113 (94.6)	0.132
Yearly dental visit>1 time		1,268 (30.1)	34 (31.1)	0.829
DMFT Experienced		3,766 (89.7)	116 (92.2)	0.417
Periodontal status				0.836
20-29 yrs (N=492)	Healthy	247 (51.9)	2 (25.3)
	Gingivitis	118 (22.7)	1 (29.5)
	Periodontitis	127 (25.3)	3 (45.3)
30-39 yrs (N=818)	Healthy	443 (52.3)	17 (57.0)
	Gingivitis	219 (28.0)	9 (23.9)
	Periodontitis	156 (19.6)	4 (19.1)
40-49 yrs (N=821)	Healthy	410 (49.7)	16 (38.4)
	Gingivitis	223 (26.6)	10 (28.7)
	Periodontitis	188 (23.6)	9 (32.8)
50-59 yrs (N=962)	Healthy	482 (50.8)	7 (46.8)
	Gingivitis	268 (27.0)	4 (30.0)
	Periodontitis	212 (22.2)	3 (23.2)
60-69 yrs (N=821)	Healthy	435 (51.3)	6 (44.4)
	Gingivitis	224 (29.4)	6 (34.6)
	Periodontitis	162 (19.4)	4 (21.0)
≥70 yrs (N=628)	Healthy	323 (51.5)	23 (67.3)
	Gingivitis	188 (30.2)	8 (20.3)
	Periodontitis	117 (18.3)	6 (12.4)

Complex weighted sample design with Chi-square test. The data were analysed by reflecting complex weighted sample design.

Table 4.

Sociodemographic characteristics of the subjects according to Anemia

Variable		Anemia		P-value
Variable		No	Yes	P-value
Gender	Male Female	2,015 (52.5) 2,537 (47.5)	91 (19.9) 286 (80.1)	<0.0001
Age	20-29	493 (17.9)	18 (7.3)
	30-39	826 (20.2)	66 (20.9)
	40-49	822 (21.5)	84 (29.1)	<0.0001
	50-59	962 (21.1)	36 (11.5)	<0.0001
	60-69	821 (11.6)	69 (12.9)
	≥70	628 (7.7)	104 (18.3)
Education	Lower middle school	1,367 (24.4)	136 (31.7)
	High school	1,366 (37.9)	118 (38.2)	0.012
	College	1,393 (37.7)	89 (30.1)
Income	Low	1,098 (25.2)	90 (23.3)
	Moderate-low	1,143 (24.9)	103 (30.7)
	Moderate-High	1,152 (24.7)	94 (23.6)	0.267
	High	1,142 (25.2)	85 (22.3)
Smoking	No	3,376 (74.5)	328 (92.9)
	Yes	893 (25.5)	29 (7.1)	<0.0001
Alcohol drinking	No	500 (9.0)	60 (14.7)	0.001
	Yes	3,776 (91)	297 (85.3)	0.001
Hypertension	No	3,299 (84.9)	243 (77.1)	<0.0001
	Yes	856 (15.1)	105 (22.9)	<0.0001
Diabetes mellitus	No	3,834 (94.2)	292 (87.1)	<0.0001
	Yes	320 (5.8)	55 (12.9)	<0.0001
Cardiac disease	No	4,069 (98.6)	329 (95.6)	<0.0001
	Yes	85 (1.4)	18 (4.4)	<0.0001
Dyslipidemia	No	3,575 (89.2)	298 (89.1)	0.943
	Yes	580 (10.8)	50 (10.9)	0.943

Complex weighted sample design with Chi-square test.

Table 5.

Odds ratio and logistic regression analysis for association Anemia

Variable	Univariate			multivariate
Variable	OR	95% CI	P-value	OR	95% CI	P-value
Gender (female)	4.182	2.561-6.828	<0.0001	3.177	1.853-5.449	<0.0001
Smoking (yes)	0.181	0.085-0.389	<0.0001	0.346	0.158-0.757	0.008
Diabetes mellitus (yes)	2.945	1.740-4.984	<0.0001	3.219	1.944-5.331	<0.0001
Cardiac disease (yes)	2.879	1.161-7.141	0.023	2.170	0.892-5.280	0.087

The data were analysed by reflecting complex weighted sample design. CI: Confidence interval; OR: Odds ratio.

Table 6.

Sociodemographic characteristics and risk factors of the subjects according to periodontal disease

Variable		periodontal disease		P-value
Variable		No	Yes	P-value
Gender	Male	1173 (48.2)	500 (51.1)	0.150
	Female	1640 (51.8)	688 (48.9)
Age	20-29	256 (15.5)	146 (19.7)	0.026*
	30-39	498 (20.5)	179 (17)
	40-49	490 (21.2)	222 (23)
	50-59	550 (20)	235 (20)
	60-69	501 (12)	195 (10.4)
	≥70	518 (10.8)	211 (9.8)
Education	Lower middle school	841 (24.9)	364 (25)	0.998
	High school	829 (37.8)	338 (37.7)
	College	829 (37.4)	345 (37.3)
Income	Low	696 (25.3)	290 (25.6)	0.965
	Moderate-low	687 (24.6)	306 (25.4)
	Moderate-High	710 (25)	295 (24.3)
	High	706 (25.1)	290 (24.8)
Smoking	No	2095 (77.4)	872 (74.9)	0.156
	Yes	479 (22.6)	219 (25.1)
Alcohol drinking	No	328 (10)	144 (9.6)	0.722
	Yes	2249 (90)	949 (90.4)
Hypertension	No	1930 (82.3)	834 (85.4)	0.030*
	Yes	596 (17.7)	221 (14.6)
Diabetes mellitus	No	2285 (92.9)	957 (93.3)	0.640
	Yes	239 (7.1)	98 (6.7)
Cardiac disease	No	2466 (98.5)	1028 (98.3)	0.649
	Yes	59 (1.5)	27 (1.7)
Dyslipidemia	No	2147 (87.9)	909 (89.8)	0.138
	Yes	379 (12.1)	146 (10.2)
Anemia	No	2276 (93.4)	963 (93)	0.670
	Yes	203 (6.6)	83 (7)

Complex weighted sample design with Chi-square test.

Table 7.

Risk variable according to periodontal disease

Variable	Univariate
Variable	OR	95% CI
Hypertension (yes)	0.792*	0.641-0.978

Logistic regression analysis. The data were analysed by reflecting complex weighted sample design. CI: Confidence interval; OR: Odds ratio. *P-value<0.05.

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