北京大学学报（医学版）2025，Vol.57Issue(5)：852-858,7.DOI:10.19723/j.issn.1671-167X.2025.05.007
牙周炎与全身系统性疾病的思考与探索
Periodontitis and systemic diseases:Thinking and explorations
摘要
Abstract
Periodontitis has become one of the most widespread chronic inflammatory diseases world-wide,affecting roughly 11％of the adult population.In China,periodontal health is notably poor,with less than 10％of individuals over the age of 35 maintaining periodontal health,while the prevalence of periodontitis in middle-aged and elderly populations reaches as high as 82.6％.From a public health perspective,periodontitis not only seriously compromises oral health but is also closely linked to multiple chronic systemic diseases,including cardiovascular disease,diabetes mellitus,and cognitive impairment.A substantial body of cohort studies and meta-analyses consistently demonstrate that patients with peri-odontitis are at a significantly increased risk of cardiovascular events.Moreover,periodontitis tends to progress more rapidly in individuals with diabetes,highlighting a bidirectional causal relationship between these two conditions.Our research team has maintained a long-term focus on elucidating the relationship between periodontitis and systemic diseases within Chinese community populations.In this review,we comprehensively summarize epidemiological findings on the associations between periodontitis and cardio-vascular disease,metabolic syndrome,and cognitive decline,specifically drawing on data from Chinese cohorts.Complementing these observations,animal experiments provide evidence that experimental peri-odontitis can induce glucose intolerance and accelerate the development of atherosclerotic lesions.At the mechanistic level,we preliminarily validate that mitochondrial DNA efflux and the hematogenous spread of periodontal pathogens may act as biological conduits bridging local periodontal inflammation with sys-temic pathologies.We also address current challenges in the field,including difficulties in disentangling causal relationships due to confounding comorbidities like diabetes and cardiovascular diseases,which of-ten coexist and influence each other.To advance understanding,there is an urgent need for well-designed longitudinal and interventional studies employing advanced causal inference methods.Ultimately,this work aims to deepen the current knowledge of periodontitis' systemic effects and to support the develop-ment of evidence-based public health strategies for integrating oral health into chronic disease prevention efforts in China.关键词
牙周炎/全身系统性疾病/心血管疾病/糖尿病/认知障碍/线粒体DNA/致病菌播散Key words
Periodontitis/Systemic diseases/Cardiovascular disease/Diabetes mellitus/Cognitive im-pairment/Mitochondrial DNA/Pathogen dissemination分类
医药卫生引用本文复制引用
曹沛,栾庆先..牙周炎与全身系统性疾病的思考与探索[J].北京大学学报（医学版）,2025,57(5):852-858,7.基金项目
国家重点研发计划项目(2023YFC2506300)和国家自然科学基金(82370956)Supported by the National Key Research and Develop-ment Program of China(2023YFC2506300)and the National Natural Science Foundation of China(82370956) （2023YFC2506300）
