Abstract
BackgroundIn COPD patients, fatal and non-fatal respiratory-related events are influenced by age, severity of respiratory disease, and comorbidities.ObjectivesAnalyze the effects of edentulism, periodontal disease and systemic biomarkers of inflammation on the occurrence of serious fatal and non-fatal respiratory-related events among subjects with COPD.MethodsCases were identified from Dental Atherosclerosis Risk in Communities study. Edentulism was defined as study participants without any natural teeth or implants. Participants with one or more natural teeth (comprising 11,378 subjects) were studied as dentate subjects. Periodontal disease status among dentate individuals was determined using the consensus definitions published by the joint Center for Disease Control/American Association of Periodontology working group). Adjusted Hazard Models are developed to evaluate the relationship between edentulism/periodontal disease and COPD Related Events. Models were then stratified by GOLD Stage I, II and III/IV. Serum biomarkers were also evaluated to explore the effect of systemic inflammation.ResultsA statistically significant association was found between oral health status and COPD-related events, even adjusting for conditions such as hypertension, smoking and diabetes. Edentulous individuals who had been diagnosed with COPD had a higher incidence and were at greater risk of having a COPD related event (hospitalization and death) than individuals who had teeth and whose mouths had healthy periodontal status. However, being edentulous did not convey excess risk for COPD-related events for those study participants who were classified as GOLD III/IV at baseline. Finally, we showed that individuals who had levels of serum IL-6 in the highest two quartiles were at even higher risk for COPD-related events.ConclusionsThese findings suggest that the risk for COPD-related events after adjusting for potential confounders may be attributable to both edentulism and elevated serum IL-6 levels.
Highlights
Non-Communicable Diseases (NCDs) including chronic respiratory diseases, together with diabetes, cancer and cardiovascular diseases, are the leading cause of disease burden and mortality in the world
These findings suggest that the risk for Chronic obstructive pulmonary disease (COPD)-related events after adjusting for potential confounders may be attributable to both edentulism and elevated serum IL-6 levels
Data from individuals participating in the Dental Atherosclerosis Risk in Communities (D-ARIC) study were used to examine the associations between edentulism, periodontal disease, and systemic biomarkers of inflammation, and the risk of serious fatal and nonfatal COPD-related events
Summary
Non-Communicable Diseases (NCDs) including chronic respiratory diseases, together with diabetes, cancer and cardiovascular diseases, are the leading cause of disease burden and mortality in the world. Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death world-wide and the third leading cause of death in the United States, affecting as many as 24 million Americans and resulting in 700,000 hospital admissions, and 124,000 deaths annually [1]. Data from our research group demonstrated a significant association between prior COPD and edentulism [8]. This observation correlates well with a study that resulted in the identification of diverse microbes, including respiratory pathogens on the surfaces of dentures [9]. In COPD patients, fatal and non-fatal respiratory-related events are influenced by age, severity of respiratory disease, and comorbidities
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