대한치위생과학회지 (Journal of Korean Dental Hygiene Science)

대한치과위생학회 & 한국치위생과학회 (The Korean Academy of Dental Hygiene & The Korean Society of Dental Hygiene Science)
권호 표지
DOI QR코드

DOI QR Code

한국인에서 비만에 따른 신체활동와 치주질환과의 연관성

Association between physical activity and periodontitis as stratified by obesity in Koreans

  • Mi-Sun Kim (Department of Dental Hygiene, Kyungdong University) ;
  • Hye-Sun Shin (Department of Dental Hygiene, Dongnam Health University)
  • 투고 : 2023.06.03
  • 심사 : 2023.06.16
  • 발행 : 2023.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

연구의 배경 및 목적: 본 연구의 목적은 한국인에서 신체활동과 치주염 사이의 연관성을 조사하는 것이다. 연구방법: 국민건강영양조사 2012년과 2013년 자료를 활용하여 우리나라 성인 9,191명에 대해 분석하였다. 치주 상태 조사는 지역사회치주요양필요지수(Community Periodontal Index, CPI)를 이용하여 CPI 3과 4를 치주염으로 정의하였다. 신체활동은 단축형 국제신체활동설문(International Physical Activity Questionnaire-Short Form, IPAQ-SF)을 이용하여 걷기 활동, 중등도 활동, 격렬한 활동으로 분류하여 분석하였다. 주요 변수간의 연관성은 로지스틱 회귀분석을 적용하였고, 비만 변수에 대해 층화분석을 적용하였다. 모든 분석은 성별에 따른 신체활동 수준의 차이가 있으므로 남녀를 나누어 분석하였다. 결과: 남성에서 치주염 유병률은 33.9%, 여성에서 치주염 유병률은 22.2%였다. 격렬한 신체활동과 중등도 신체활동을 하는 여성그룹에서 치주염 유병률이 각각 28% (OR=0.72, 95% CI=0.54-0.95), 34% ((OR=0.66, 95% CI=0.44-0.98) 낮았다. 반면 남성에서는 유의한 연관성을 보이지 않았다. 비만인 여성그룹에서는 중등도 활동을 한 그룹에서 65% (OR=0.35, 95% CI=0.18-0.67)의 더 높은 신체활동 감소와 연관성이 있었다. 결론: 본 연구조사 결과 중등도 신체활동은 치주염과 음의 연관성(inverse association)이 있다는 것을 보여주었다. 비만 여성에서는 중등도 신체활동이 치주염과 독립적으로 연관성이 있고 비만 변수가 효과변경인자(effect modifier)가 된다는 것을 확인하였다.

Background: The aim of this study was to examine the association between physical activity and periodontitis in the Korean population. Methods: This study utilized data from 9,191 participants of the Korea National Health and Nutrition Examination Survey. Periodontitis was defined as a CPI score of 3 or 4. Physical activity was assessed by the trained interviewer using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). IPAQ-SF is composed of vigorous physical activity, moderate physical activity, and walking activity. Multivariable logistic regression analyses and stratified analyses by obesity were performed. All analyses were conducted separately for males and females. Results: Females who engaged in vigorous and moderate physical activity had a 28% (OR = 0.72, 95% CI = 0.54 - 0.95) and 34% (OR = 0.66, 95% CI = 0.44 - 0.98) lower risk of periodontitis, respectively. In obese females, moderate physical activity in obese had a 65% lower risk of periodontitis (OR = 0.35, 95% CI = 0.18 - 0.67). Conclusions: Our findings suggest that moderate-intensity physical activity was inversely associated with a lower risk of periodontitis. In obese females, moderate physical activity had an independent inverse association with periodontitis.

키워드

과제정보

The author has no conflict of interest to disclose. Financial Support This research was supported by Kyungdong University Research Fund, 2022.

참고문헌

  1. Pihlstrom BL, et al. Periodontal diseases. Lancet 2005;366:1809-1820. doi: 10.1016/S0140-6736(05)67728-8. 
  2. World Health Organization. Global recommendations on physical activity for health. Available at: http://www.who.int/dietphysicalactivity/factsheet_adults/en/.Accessed:02Jan,2018. 
  3. Ding D, et al. The economic burden of physical inactivity: a global analysis of major noncommunicable diseases. Lancet 2016;388:1311-1324. doi: 10.1016/S0140-6736(16)30383-X. 
  4. Korea Center for Disease Control and Prevention. Korea Health Statistics 2013: Korea national Health and Nutrition Examination Survey (KNHANES), 2013. 
  5. Wakai K, et al. Associations of medical status and physical fitness with periodontal disease. J Clin Periodontol 1999;26:664-672. doi: 10.1034/j.1600-051x.1999.261006.x. 
  6. Merchant AT, et al. Increased physical activity decreases periodontitis risk in men. Eur J Epidemiol 2003;18:891-898. doi: 10.1023/a:1025622815579. 
  7. Al-Zahrani MS, et al. Periodontitis and three health-enhancing behaviors: maintaining normal weight, engaging in recommended level of exercise, and consuming a high-quality diet. J Periodontol 2005;76:1362-1366. doi: 10.1902/jop.2005.76.8.1362. 
  8. Al-Zahrani MS, et al. Increased physical activity reduces prevalence of periodontitis. Journal of dentistry 2005;33:703-710. doi: 10.1016/j.jdent.2005.01.004. 
  9. Sanders AE, et al. Physical activity, inflammatory biomarkers in gingival crevicular fluid and periodontitis. J Clin Periodontol 2009;36:388-395. doi: 10.1111/j.1600-051X.2009.01394.x. 
  10. Shimazaki Y, et al. Relationship between obesity and physical fitness and periodontitis. J Periodontol 2010;81:1124-1131. doi: 10.1902/jop.2010.100017. 
  11. Oliveira JA, et al. Periodontal disease as a risk indicator for poor physical fitness: a crosssectional observational study. J Periodontol 2015;86:44-52. doi: 10.1902/jop.2014.140270. 
  12. Eremenko M, et al. Cross-sectional association between physical strength, obesity, periodontitis and number of teeth in a general population. J Clin Periodontol 2016;43:401-407. doi: 10.1111/jcpe.12531. 
  13. Hoppe CB, et al. Association between chronic oral inflammatory burden and physical fitness in males: a cross-sectional observational study. Int Endod J 2017;50:740-749. doi: 10.1111/iej.12686. 
  14. Andrade EF, et al. Exercise attenuates alveolar bone loss and anxiety-like behaviour in rats with periodontitis. J Clin Periodontol 2017;44:1153-1163. doi: 10.1111/jcpe.12794. 
  15. Arrieta A, Russell LB. Effects of leisure and nonleisure physical activity on mortality in U.S. adults over two decades. Ann Epidemiol 2008;18:889-895. doi: 10.1016/j.annepidem.2008.09.007. 
  16. Andersen LB, et al. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med 2000;160:1621-1628. doi: 10.1001/archinte.160.11.1621. 
  17. Khaw KT, et al. Work and leisure time physical activity assessed using a simple, pragmatic, validated questionnaire and incident cardiovascular disease and all-cause mortality in men and women: The European Prospective Investigation into Cancer in Norfolk prospective population study. Int J Epidemiol 2006;35:1034-1043. doi:10.1093/ije/dyl079. 
  18. Sabia S, et al. Effect of intensity and type of physical activity on mortality: results from the Whitehall II cohort study. Am J Public Health 2012;102:698-704. doi: 10.2105/AJPH.2011.300257. 
  19. Khan S, et al. Association between obesity and periodontitis in Australian adults: A single mediation analysis. J Periodontol 2021;92:514-523. doi: 10.1002/JPER.20-0044. 
  20. World Health Organization. Oral health surveys: basic methods. 1997. 
  21. Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-1395. doi:10.1249/01.MSS.0000078924.61453.FB. 
  22. Ministry of Health and Welfare. Physical activity Guidelines for Koreans. No., 2013. 
  23. Manson JE, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med 1999;341:650-658. doi: 10.1056/NEJM199908263410904. 
  24. Blair SN, Morris JN. Healthy hearts and the universal benefits of being physically active: physical activity and health. Ann Epidemiol 2009;19:253-256. doi: 10.1016/j.annepidem.2009.01.019. 
  25. Lee IM. Physical activity in women: how much is good enough? JAMA 2003;290:1377-1379. doi:10.1001/jama.290.10.1377. 
  26. Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol 2005;45:1563-1569. doi: 10.1016/j.jacc.2004.12.077. 
  27. Elhakeem A, et al. Leisure-time physical activity across adulthood and biomarkers of cardiovascular disease at age 60-64: A prospective cohort study. Atherosclerosis 2018;269:279-287. doi: 10.1016/ j.atherosclerosis.2017. 11.019. 
  28. Paraskevas S, et al. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008;35:277-290. doi: 10.1111/j.1600-051X.2007.01173.x. 
  29. Pai JK, et al. Inflammatory markers and the risk of coronary heart disease in men and women. N Engl J Med 2004;351:2599-2610. doi: 10.1056/NEJMoa040967. 
  30. Gaio EJ, et al. Effect of obesity on periodontal attachment loss progression: a 5-year populationbased prospective study. J Clin Periodontol 2016;43:557-565. doi: 10.1111/jcpe.12544.