Journal of Korean Dental Hygiene Science (대한치위생과학회지)

The Korean Academy of Dental Hygiene & The Korean Society of Dental Hygiene Science (대한치과위생학회 & 한국치위생과학회)
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Association between physical activity and periodontitis according to depression among Korean adults

한국 성인의 우울증 여부에 따른 신체활동과 치주질환 간 관련성

  • Hye-Rim Jeon (Department of Dental Hygiene, College of Dentistry, Gangneung-Wonju National University) ;
  • Soo-Myoung Bae (Department of Dental Hygiene, College of Dentistry, Gangneung-Wonju National University) ;
  • Hyo-Jin Lee (Department of Dental Hygiene, College of Dentistry, Gangneung-Wonju National University)
  • 전혜림 (강릉원주대학교 치과대학 치위생학과) ;
  • 배수명 (강릉원주대학교 치과대학 치위생학과) ;
  • 이효진 (강릉원주대학교 치과대학 치위생학과)
  • Received : 2024.06.12
  • Accepted : 2024.06.27
  • Published : 2024.06.30
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Abstract

Background: This study aimed to investigate the association between physical activity and periodontitis based on depression status in a representative sample of Korean adults. Methods: A total of 12,689 subjects who participated in the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were examined. Depression was defined as a PHQ-9 score ≥ 10. Periodontal status was assessed using the community periodontal index, with periodontitis defined as a code ≥ 3. Physical activity categories were divided into a physical activity group and a non-physical activity group, considering the number of days and minutes spent on moderate and vigorous activities. Moderate activity was defined as causing slight breathlessness or a slightly elevated heart rate, while vigorous activity was defined as causing significant breathlessness or a rapid heart rate. Multivariable logistic regression analyses were adjusted for sociodemographic variables (age, sex, education level, and household income), oral and general health behaviors (use of floss and interdental proximal brush, current smoking), and systemic health status (diabetes and hypertension). All analyses utilized a complex sampling design, and subgroup analysis was performed to estimate associations stratified by depression (PHQ-9 ≤ 9 and ≥ 10). Results: Multivariable regression analysis revealed that among participants with depression, those who did not engage in physical activity were 2.65 times more likely to have periodontitis (odds ratio = 2.65, 95% confidence interval = 1.17-6.01). Conclusion: The study findings suggest that individuals who participate in any form of physical activity may be significantly less likely to develop periodontitis, particularly within the group experiencing depression.

연구의 배경 및 목적: 본 연구는 한국 성인을 대표하는 표본을 대상으로 우울증에 따른 신체활동과 치주염의 연관성을 조사하고자 하였다. 한국 성인의 우울 증상에 따라 신체활동과 치주염 간 연관성에 차이가 있는지 파악하고자 하며, 이를 통하여 우울증 환자의 구강건강 증진 및 유지관리를 위하여 신체활동을 포함한 건강행동에 대한 기초자료를 제공하는데 근거가 되고자 한다. 연구 방법: 제7기 국민건강영양조사(2016~2018년)에 참여한 총 12,689명의 대상자를 조사하였다. 우울증은 PHQ-9 ≥ 10으로 정의했다. 치주 상태는 지역 사회 치주지수(CPI)를 사용하였다. 치주염은 코드 3 이상으로 설정했다. 구강검사는 조사지역 중 일부를 추출하여 검사를 진행하여 제 7기로 통합되어 별도 가중치가 사용되었다. 개별가중치 요인이 사용되었고, 자료 분석은 복합표본설계(Complex sampling design)를 통해 분산값을 계산했다. 신체활동은 일과 여가, 장소이동과 관련된 신체활동으로 구분되며, 본 연구에서는 일과 여가에서 약간 숨이 차거나 심장이 약간 빠르게 뛰는 활동 이상을 하는 경우와 장소이동 신체활동을 모두 포함하는 총신체활동량으로 정의하였다. 총신체활동량은 신체활동 실천 일수와 시간을 고려하여 강도에 따라 가중치를 부여하여 산출하였고, 산출된 값의 분포를 고려하여 총신체활동을 하는 집단과 하지 않는 집단으로 나누었다. 다변량 로지스틱회귀분석을 실시하고자, 사회인구학적 변수(연령, 성별, 교육수준 및 가구소득), 구강 및 건강행동(치실 및 치간칫솔 사용, 현재 흡연), 전신건강상태(당뇨병 및 고혈압) 변수를 보정하였다. 우울증 여부에 따라 층화분석을 실시하여 신체활동과 치주염 간 연관성 차이를 분석하였다. 결과: 다변수 로지스틱회귀모형에서 우울증이 있는 대상자 중 신체활동을 하지 않는 집단은 신체활동을 하는 집단보다 치주질환의 위험성이 2.65배(오즈비 = 2.65, 95% 신뢰구간 = 1.17-6.01) 높은 것으로 나타났다. 결론: 우울증이 있는 경우 신체활동은 치주염과 유의하게 관련이 있는 것으로 나타났다.

Keywords

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