期刊
JOURNAL OF DIABETES AND ITS COMPLICATIONS
卷 33, 期 9, 页码 603-609出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2019.05.025
关键词
Type 1 diabetes; Periodontal disease; Coronary artety disease; Smoking; Diabetes complications
资金
- NIH [DK34818]
- Rossi Memorial Fund
Aim: To assess the role of periodontal disease (PD) as a predictor of coronary artery disease (CAD) and mortality in a prospective type 1 diabetes (T1D) cohort and to evaluate the role of smoking in this relationship. Methods: Data were based on 320 participants of the Pittsburgh Epidemiology of Diabetes Complications study of T1D who, during 1992-94, received a partial mouth periodontal exam, and who were followed for up to 19 years to ascertain complication incidence. PD was defined as clinical attachment loss of >= 4 mm for at least 10% of the examined sites. Predictors of all-cause mortality; Hard CAD (CAD death, myocardial infarction or revascularization), and Total CAD (Hard CAD, angina, ischemic ECG) were assessed using Cox models. Results: During 19 years of follow-up, 33.7% (97/288) developed CAD, 27.3% (83/304) developed Hard CAD, and 16.9% (54/320) died. Among current smokers, 46.4% (26/56) developed CAD, 42.7% (24/56) developed Hard CAD and 29.5% (18/61) died. PD was not associated with all-cause mortality, although it was a significant predictor of both CAD (HR = 1.12, CI = 1.01-1.23) and Hard CAD (HR = 130, CI = 1.11-1.51). As smoking modified the PD CAD and PD-Hard CAD associations, analyses were stratified by smoking status. PD was associated with an increased risk of CAD (HR = 1.25, CI = 1.03-1.50) and Hard CAD (HR = 1.85, CI = 1.17-2.93) only among smokers. Conclusion: PD was a significant predictor of CAD and Hard CAD among current smokers with T1D. (C) 2019 Elsevier Inc. All rights reserved.
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