Objective: To investigate the association between osteoporosis and severe periodontal attachment loss in postmenopausal women. Methods: One hundred and ninety-five postmenopausal women aged 50-65 years old were included in the present study. The participant were recruited from patients in the Peking University International Hospital and through website from March, 2017 to August, 2018. Periodontal examination, filling out a structured questionnaire and bone mass density (BMD) examination were completed to each of the participants. The clinical attachment loss (CAL), oral hygiene index simplified (OHI-S), and bleeding on probing (BOP) were examined and recorded as periodontal parameters. The structured questionnaire was used to collect information of the physical activity, socioeconomic status, marital status, oral health habits, and so on. Bone mass density of the lumbar spine and left hip were scanned by using standardized dual energy X-ray absorptiometry. Based on the T-score of BMD (difference between the measured BMD and the mean value of young white women in terms of standard deviations), osteoporosis was defined as T-score≤-2.5 (according to the World Health Organization criteria). Fourteen risk factors were preliminarily screened by chi-square test, including age, duration of menopause, body mass index (BMI), exercise habit, economic status, marital status, level of education, habit of dental visit, tooth brushing habit, usage of interdental tools, OHI-S, BOP(+)%, osteoporosis in hip and osteoporosis in lumbar. Factors with P<0.05 were selected for multivariate Logistic regression analysis. Logistic regression was used to analysis the risk factors of severe periodontal attachment loss. Results: The mean age of 195 postmenopausal women was (57.8±4.3) years. After adjusting for ages, the economic status, habit of dental visit, OHI-S and BOP(+)%, there was an association of osteoporosis in hip and severe periodontal attachment loss in postmenopausal women [odds ratios (OR)=2.466, 95% confidence intervals (CI) was 1.173-5.185, P=0.017]. Conclusions: Postmenopausal women with osteoporosis in hip has a greater chance of presenting severe periodontal attachment loss.
目的： 研究绝经期女性骨质疏松与牙周重度附着丧失的相关性。 方法： 纳入2017年3月至2018年8月在北京大学国际医院就诊，以及在此期间通过网络招募的50至65岁绝经期女性195例，进行牙周检查、填写调查问卷并接受骨密度检查。牙周检查指标包括：临床附着丧失（clinical attachment loss，CAL）、简化口腔卫生指数（oral hygiene index simplified，OHI-S）、探诊出血阳性位点（bleeding on probing，BOP）百分比[BOP（+）%]。受试者口内牙齿存在CAL≥5 mm的位点不少于3处且位于不同象限时，计为重度CAL。受试者填写调查问卷，内容包括一般身体状况、生活习惯、社会经济背景、婚姻情况、口腔就诊情况和口腔卫生维护情况等。使用双能X线骨密度测量仪检查受试者左侧髋部以及腰椎的骨密度。按照世界卫生组织的标准，当骨密度与年轻白人健康女性骨密度峰值标准差的倍数（T值）≤-2.5时，诊断为骨质疏松。采用卡方检验，对年龄、绝经时间、体重指数、锻炼习惯、家庭收入、婚姻状况、教育程度、口腔就诊习惯、刷牙习惯、牙齿邻面清洁工具的使用、OHI-S、BOP（+）%、髋部骨质疏松、腰椎骨质疏松等14个因素进行初筛，选取P<0.05的因素进行多因素Logistic分析。采用Logistic回归分析评价骨质疏松与牙周重度CAL发生的相关性。 结果： 195例绝经期女性年龄（57.8±4.3）岁，其中有重度牙周CAL者111例（56.9%），骨质疏松者89例（45.6%）。对年龄、家庭收入、口腔就诊习惯、OHI-S、BOP（+）%和髋部骨质疏松6个风险因素的回归分析结果显示，差异有统计学意义的3个因素OR值分别为：髋部骨质疏松（OR=2.466）、OHI-S（OR=2.262）、BOP(+)%（OR=7.274），这3个因素是绝经期女性发生重度CAL的危险因素。髋部骨质疏松的绝经期女性发生牙周重度CAL的风险是无骨质疏松者的2.466倍（P=0.017）。 结论： 髋部骨质疏松的绝经期女性发生牙周重度附着丧失的风险增加。.
Keywords: Menopause; Osteoporosis, postmenopausal; Severe periodontal attachment loss.