TY - JOUR
T1 - Oral Condition and Incident Coronary Heart Disease: A Clustering Analysis
AU - Deraz, O.
AU - Range, H.
AU - Boutouyrie, P.
AU - Chatzopoulou, E.
AU - Asselin, A.
AU - Guibout, C.
AU - Van Sloten, T.
AU - Bougouin, W.
AU - Andrieu, M.
AU - Vedie, B.
AU - Thomas, F.
AU - Danchin, N.
AU - Jouven, X.
AU - Bouchard, P.
AU - Empana, J.P.
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The PPS3 was supported by grants from the National Research Agency, the Research Foundation for Hypertension, the Research Institute in Public Health, the Region Ile de France (Domaine d’Intérêt Majeur), and European Horizon 2020. O. Deraz was also supported by a grant of the UFR of Odontology, University of Paris Garancière.
Funding Information:
We thank N. Estrugo, S. Yanes, J.F. Pruny, and J. Lacet Machado for performing the recruitment of the Paris Prospective Study 3 (PPS3) participants and Dr. M.F. Eprinchard, Dr. J.M. Kirzin, and all the medical and technical staff of the IPC Center (Centre d?Investigations Pr?ventives et Cliniques), the Centre de Ressources Biologiques de l?H?pital European Georges Pompidou (C. de Toma, G Daniela, B. Vedie), and the Platform for Biological Resources of the H?pital Europ?en Georges Pompidou for the management of the biobank. We also thank Celine Bertholle from the Cochin Cytometry and Immunobiology core facility for her excellent technical help in the measurements of CRP, IL-6, and NTproBNP in PPS3. The PPS3 is organized under an agreement between INSERM and the IPC Center and between INSERM and the Ressources Biologiques de l?H?pital European Georges Pompidou, Paris, France. We also thank the Caisse Nationale d?Assurance Maladie des Travailleurs Salari?s and the Caisse Primaire d?Assurance Maladie de Paris for helping make this study possible. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The PPS3 was supported by grants from the National Research Agency, the Research Foundation for Hypertension, the Research Institute in Public Health, the Region Ile de France (Domaine d?Int?r?t Majeur), and European Horizon 2020. O. Deraz was also supported by a grant of the UFR of Odontology, University of Paris Garanci?re.
Publisher Copyright:
© International Association for Dental Research and American Association for Dental, Oral, and Craniofacial Research 2021.
PY - 2022/5
Y1 - 2022/5
N2 - Poor oral health has been linked to coronary heart disease (CHD). Clustering clinical oral conditions routinely recorded in adults may identify their CHD risk profile. Participants from the Paris Prospective Study 3 received, between 2008 and 2012, a baseline routine full-mouth clinical examination and an extensive physical examination and were thereafter followed up every 2 y until September 2020. Three axes defined oral health conditions: 1) healthy, missing, filled, and decayed teeth; 2) masticatory capacity denoted by functional masticatory units; and 3) gingival inflammation and dental plaque. Hierarchical cluster analysis was performed with multivariate Cox proportional hazards regression models and adjusted for age, sex, smoking, body mass index, education, deprivation (EPICES score; Evaluation of Deprivation and Inequalities in Health Examination Centres), hypertension, type 2 diabetes, LDL and HDL serum cholesterol (low- and high-density lipoprotein), triglycerides, lipid-lowering medications, NT-proBNP and IL-6 serum level. A sample of 5,294 participants (age, 50 to 75 y; 37.10% women) were included in the study. Cluster analysis identified 3,688 (69.66%) participants with optimal oral health and preserved masticatory capacity (cluster 1), 1,356 (25.61%) with moderate oral health and moderately impaired masticatory capacity (cluster 2), and 250 (4.72%) with poor oral health and severely impaired masticatory capacity (cluster 3). After a median follow-up of 8.32 y (interquartile range, 8.00 to 10.05), 128 nonfatal incident CHD events occurred. As compared with cluster 1, the risk of CHD progressively increased from cluster 2 (hazard ratio, 1.45; 95% CI, 0.98 to 2.15) to cluster 3 (hazard ratio, 2.47; 95% CI, 1.34 to 4.57; P < 0.05 for trend). To conclude, middle-aged individuals with poor oral health and severely impaired masticatory capacity have more than twice the risk of incident CHD than those with optimal oral health and preserved masticatory capacity (ClinicalTrials.gov NCT00741728).
AB - Poor oral health has been linked to coronary heart disease (CHD). Clustering clinical oral conditions routinely recorded in adults may identify their CHD risk profile. Participants from the Paris Prospective Study 3 received, between 2008 and 2012, a baseline routine full-mouth clinical examination and an extensive physical examination and were thereafter followed up every 2 y until September 2020. Three axes defined oral health conditions: 1) healthy, missing, filled, and decayed teeth; 2) masticatory capacity denoted by functional masticatory units; and 3) gingival inflammation and dental plaque. Hierarchical cluster analysis was performed with multivariate Cox proportional hazards regression models and adjusted for age, sex, smoking, body mass index, education, deprivation (EPICES score; Evaluation of Deprivation and Inequalities in Health Examination Centres), hypertension, type 2 diabetes, LDL and HDL serum cholesterol (low- and high-density lipoprotein), triglycerides, lipid-lowering medications, NT-proBNP and IL-6 serum level. A sample of 5,294 participants (age, 50 to 75 y; 37.10% women) were included in the study. Cluster analysis identified 3,688 (69.66%) participants with optimal oral health and preserved masticatory capacity (cluster 1), 1,356 (25.61%) with moderate oral health and moderately impaired masticatory capacity (cluster 2), and 250 (4.72%) with poor oral health and severely impaired masticatory capacity (cluster 3). After a median follow-up of 8.32 y (interquartile range, 8.00 to 10.05), 128 nonfatal incident CHD events occurred. As compared with cluster 1, the risk of CHD progressively increased from cluster 2 (hazard ratio, 1.45; 95% CI, 0.98 to 2.15) to cluster 3 (hazard ratio, 2.47; 95% CI, 1.34 to 4.57; P < 0.05 for trend). To conclude, middle-aged individuals with poor oral health and severely impaired masticatory capacity have more than twice the risk of incident CHD than those with optimal oral health and preserved masticatory capacity (ClinicalTrials.gov NCT00741728).
KW - coronary disease
KW - cardiovascular diseases
KW - biomarkers
KW - oral health
KW - primary prevention
KW - cluster analysis
KW - TOOTH LOSS
KW - MICROBIOTA
KW - ASSOCIATION
KW - PERFORMANCE
KW - BURDEN
KW - HEALTH
KW - RISK
KW - GUT
U2 - 10.1177/00220345211052507
DO - 10.1177/00220345211052507
M3 - Article
C2 - 34875909
SN - 0022-0345
VL - 101
SP - 526
EP - 533
JO - Journal of Dental Research
JF - Journal of Dental Research
IS - 5
M1 - 00220345211052507
ER -