Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults

China Kadoorie Biobank (CKB) collaborative group

doi:10.1111/eci.13634

Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults

China Kadoorie Biobank (CKB) collaborative group

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.

Original language	English
Article number	e13634
Journal	European Journal of Clinical Investigation
Volume	51
Issue number	12
Early online date	21 Jun 2021
DOIs	https://doi.org/10.1111/eci.13634
Publication status	Published - 17 Nov 2021

Funder

National Natural Science Foundation of China (81941018, 91846303,91843302, 81390540,81390541, 81390544). The CKB baseline survey and the first resurvey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504,2016YFC1303904) from The National Key R&D Program of China, and Chinese Ministry of Science and Technology (2011BAI09B01).

Funding

This work was supported by National Natural Science Foundation of China (81941018, 91846303,91843302, 81390540,81390541, 81390544). The CKB baseline survey and the first resurvey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504,2016YFC1303904) from The National Key R&D Program of China, and Chinese Ministry of Science and Technology (2011BAI09B01). The funders had no role in the study design, data collection, data analysis and interpretation, writing of the report, or the decision to submit the article for publication The most important acknowledgement is to the participants in the study and the members of the survey teams in each of the 10 regional centres, as well as to the project development and management teams based at Beijing, Oxford and the 10 regional centres. Members Of The China Kadoorie Biobank Collaborative Group International Steering Committee: Junshi Chen, Zhengming Chen (PI), Robert Clarke, Rory Collins, Yu Guo, Liming Li (PI), Jun Lv, Richard Peto, Robin Walters. International Co-ordinating Centre, Oxford: Daniel Avery, Ruth Boxall, Derrick Bennett, Yumei Chang, Yiping Chen, Zhengming Chen, Robert Clarke, Huaidong Du, Simon Gilbert, Alex Hacker, Mike Hill, Michael Holmes, Andri Iona, Christiana Kartsonaki, Rene Kerosi, Ling Kong, Om Kurmi, Garry Lancaster, Sarah Lewington, Kuang Lin, John McDonnell, Iona Millwood, Qunhua Nie, Jayakrishnan Radhakrishnan, Paul Ryder, Sam Sansome, Dan Schmidt, Paul Sherliker, Rajani Sohoni, Becky Stevens, Iain Turnbull, Robin Walters, Jenny Wang, Lin Wang, Neil Wright, Ling Yang, Xiaoming Yang. National Co-ordinating Centre, Beijing: Zheng Bian, Yu Guo, Xiao Han, Can Hou, Jun Lv, Pei Pei, Chao Liu, Yunlong Tan, Canqing Yu. 10 Regional Co-ordinating Centres: Qingdao CDC: Zengchang Pang, Ruqin Gao, Shanpeng Li, Shaojie Wang, Yongmei Liu, Ranran Du, Yajing Zang, Liang Cheng, Xiaocao Tian, Hua Zhang, Yaoming Zhai, Feng Ning, Xiaohui Sun, Feifei Li. Licang CDC: Silu Lv, Junzheng Wang, Wei Hou. Heilongjiang Provincial CDC: Mingyuan Zeng, Ge Jiang, Xue Zhou. Nangang CDC: Liqiu Yang, Hui He, Bo Yu, Yanjie Li, Qinai Xu, Quan Kang, Ziyan Guo. Hainan Provincial CDC: Dan Wang, Ximin Hu, Jinyan Chen, Yan Fu, Zhenwang Fu, Xiaohuan Wang. Meilan CDC: Min Weng, Zhendong Guo, Shukuan Wu, Yilei Li, Huimei Li, Zhifang Fu. Jiangsu Provincial CDC: Ming Wu, Yonglin Zhou, Jinyi Zhou, Ran Tao, Jie Yang, Jian Su. Suzhou CDC: Fang liu, Jun Zhang, Yihe Hu, Yan Lu, Liangcai Ma, Aiyu Tang, Shuo Zhang, Jianrong Jin, Jingchao Liu. Guangxi Provincial CDC: Zhenzhu Tang, Naying Chen, Ying Huang. Liuzhou CDC: Mingqiang Li, Jinhuai Meng, Rong Pan, Qilian Jiang, Jian Lan, Yun Liu, Liuping Wei, Liyuan Zhou, Ningyu Chen Ping Wang, Fanwen Meng, Yulu Qin, Sisi Wang. Sichuan Provincial CDC: Xianping Wu, Ningmei Zhang, Xiaofang Chen, Weiwei Zhou. Pengzhou CDC: Guojin Luo, Jianguo Li, Xiaofang Chen, Xunfu Zhong, Jiaqiu Liu, Qiang Sun. Gansu Provincial CDC: Pengfei Ge, Xiaolan Ren, Caixia Dong. Maiji CDC: Hui Zhang, Enke Mao, Xiaoping Wang, Tao Wang, Xi zhang. Henan Provincial CDC: Ding Zhang, Gang Zhou, Shixian Feng, Liang Chang, Lei Fan. Huixian CDC: Yulian Gao, Tianyou He, Huarong Sun, Pan He, Chen Hu, Xukui Zhang, Huifang Wu, Pan He. Zhejiang Provincial CDC: Min Yu, Ruying Hu, Hao Wang. Tongxiang CDC: Yijian Qian, Chunmei Wang, Kaixu Xie, Lingli Chen, Yidan Zhang, Dongxia Pan, Qijun Gu. Hunan Provincial CDC: Yuelong Huang, Biyun Chen, Li Yin, Huilin Liu, Zhongxi Fu, Qiaohua Xu. Liuyang CDC: Xin Xu, Hao Zhang, Huajun Long, Xianzhi Li, Libo Zhang, Zhe Qiu. This work was supported by National Natural Science Foundation of China (81941018, 91846303,91843302, 81390540,81390541, 81390544). The CKB baseline survey and the first resurvey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long‐term follow‐up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504,2016YFC1303904) from The National Key R&D Program of China, and Chinese Ministry of Science and Technology (2011BAI09B01). The funders had no role in the study design, data collection, data analysis and interpretation, writing of the report, or the decision to submit the article for publication

Funders	Funder number
National Natural Science Foundation of China	81390544, 81941018, 91846303,91843302, 81390540,81390541
Chinese Ministry of Science and Technology	2011BAI09B01
National Key Research and Development Program of China	YFC1303904, 2016YFC0900500, 2016YFC0900501, 2016YFC0900504

Keywords

cardiovascular disease
cohort study
dental public health
epidemiology
oral hygiene

ASJC Scopus subject areas

Biochemistry
Clinical Biochemistry

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/eci.13634

Cite this

@article{f03932a3c517403ea856be6d9361f8af,

title = "Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults",

abstract = "Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.",

keywords = "cardiovascular disease, cohort study, dental public health, epidemiology, oral hygiene",

author = "{China Kadoorie Biobank (CKB) collaborative group} and Zhenhuang Zhuang and Meng Gao and Jun Lv and Canqing Yu and Yu Guo and Zheng Bian and Ling Yang and Huaidong Du and Yiping Chen and Feng Ning and Huilin Liu and Junshi Chen and Zhengming Chen and Tao Huang and Liming Li and Robert Clarke and Rory Collins and Richard Peto and Robin Walters and Daniel Avery and Ruth Boxall and Derrick Bennett and Yumei Chang and Simon Gilbert and Alex Hacker and Mike Hill and Michael Holmes and Andri Iona and Christiana Kartsonaki and Rene Kerosi and Ling Kong and Om Kurmi and Garry Lancaster and Sarah Lewington and Kuang Lin and John McDonnell and Iona Millwood and Qunhua Nie and Jayakrishnan Radhakrishnan and Paul Ryder and Sam Sansome and Dan Schmidt and Paul Sherliker and Rajani Sohoni and Becky Stevens and Iain Turnbull and Jenny Wang and Lin Wang and Neil Wright and Xiaoming Yang",

year = "2021",

month = nov,

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doi = "10.1111/eci.13634",

language = "English",

volume = "51",

journal = "European Journal of Clinical Investigation",

issn = "0014-2972",

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AU - China Kadoorie Biobank (CKB) collaborative group

AU - Zhuang, Zhenhuang

AU - Gao, Meng

AU - Lv, Jun

AU - Yu, Canqing

AU - Guo, Yu

AU - Bian, Zheng

AU - Yang, Ling

AU - Du, Huaidong

AU - Chen, Yiping

AU - Ning, Feng

AU - Liu, Huilin

AU - Chen, Junshi

AU - Chen, Zhengming

AU - Huang, Tao

AU - Li, Liming

AU - Clarke, Robert

AU - Collins, Rory

AU - Peto, Richard

AU - Walters, Robin

AU - Avery, Daniel

AU - Boxall, Ruth

AU - Bennett, Derrick

AU - Chang, Yumei

AU - Gilbert, Simon

AU - Hacker, Alex

AU - Hill, Mike

AU - Holmes, Michael

AU - Iona, Andri

AU - Kartsonaki, Christiana

AU - Kerosi, Rene

AU - Kong, Ling

AU - Kurmi, Om

AU - Lancaster, Garry

AU - Lewington, Sarah

AU - Lin, Kuang

AU - McDonnell, John

AU - Millwood, Iona

AU - Nie, Qunhua

AU - Radhakrishnan, Jayakrishnan

AU - Ryder, Paul

AU - Sansome, Sam

AU - Schmidt, Dan

AU - Sherliker, Paul

AU - Sohoni, Rajani

AU - Stevens, Becky

AU - Turnbull, Iain

AU - Wang, Jenny

AU - Wang, Lin

AU - Wright, Neil

AU - Yang, Xiaoming

PY - 2021/11/17

Y1 - 2021/11/17

N2 - Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.

AB - Accumulating evidence has shown that poor oral hygiene is associated with increased risk of cardiometabolic diseases in Western populations. However, its relevance about the relationships in Chinese adults remains unclear. The China Kadoorie Biobank enrolled 512 715 adults aged 30-79 years in China during 2004-2008. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with measures of oral hygiene. Overall 9.3% of the participants reported rarely or never brushing teeth at baseline. Participants who rarely or never brushed teeth had adjusted HR of 1.12 (95% CI: 1.09, 1.15) for MVE, with similar HRs for stroke (1.08, 1.05-1.12), intracerebral haemorrhage (1.18, 1.11-1.26) and pulmonary heart disease (1.22, 1.13-1.32) compared with those who brushed teeth regularly. Those who did not brush teeth also had increased risk of cancer (1.09, 1.04-1.14), chronic obstructive pulmonary disease (COPD) (1.12, 1.05-1.20), liver cirrhosis (1.25, 1.09-1.44) and all-cause death (1.25, 1.21-1.28) but not type 2 diabetes (0.94, 0.86-1.03) and chronic kidney disease (0.98, 0.81-1.18). Among Chinese adults, we found that poor oral hygiene is associated with higher risks of major vascular disease, cancer, COPD, liver cirrhosis and all-cause deaths, but not type 2 diabetes and chronic kidney disease.

KW - cardiovascular disease

KW - cohort study

KW - dental public health

KW - epidemiology

KW - oral hygiene

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U2 - 10.1111/eci.13634

DO - 10.1111/eci.13634

M3 - Article

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SN - 0014-2972

VL - 51

JO - European Journal of Clinical Investigation

JF - European Journal of Clinical Investigation

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ER -

Associations of toothbrushing behaviour with risks of vascular and nonvascular diseases in Chinese adults

Abstract

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Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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