Lan Wei. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 260-301). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Photocopy. Ann Arbor, Mich. : UMI Dissertation Services, 2002. xx, 301 p. : ill. ; 22 cm. / Abstracts in English and Chinese.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

A cross-sectional study of risk factors for coronary heart disease (CHD) in a random sample of 976 coloured people revealed a population greatly at risk of CHD. The major reversible risk factors were very common: 57% of men and 41% of women smoked, 17,2% of men and 18,4% of women were hypertensive (>160/95 mm Hg or receiving medication), and 17,4% of men and 16,2% of women had a total serum cholesterol value above 6,5 mmol/litre. The high cut-off points used to identify the above prevalence rate do not reflect the total population at risk. At lower but real levels of risk 94,6% of men and 89,8% of women carried some degree of CHD risk factors was found.

Introdução: A periodontite é uma doença inflamatória caracterizada clinicamente pela destruição dos tecidos de suporte dental. Apresenta etiologia multifatorial, sendo a principal causa o acúmulo de bactérias patogênicas na superfície dentária. A periodontite tem sido associada ao avanço da aterosclerose. Os indivíduos portadores da hipercolesterolemia familiar apresentam o desenvolvimento precoce da doença aterosclerótica devido à exposição crônica a níveis altos de colesterol total e LDL-colesterol. Não existem estudos que analisem a associação entre a infecção periodontal e aterosclerose subclínica nessa população. Objetivo: Este trabalho analisou a relação entre a aterosclerose, coronariana, carotídea e/ou aórtica, e a doença periodontal em indivíduos com hipercolesterolemia familiar e em controles presumidamente sem a doença. Métodos: Foram incluídos 82 indivíduos com diagnóstico de hipercolesterolemia familiar pelo critério do U.S. MEDPED e 31 indivíduos saudáveis como grupo controle. A calcificação arterial coronariana foi avaliada por tomografia computadorizada e a medida realizada pelo método de Agatston. O espessamento médio-intimal carotídeo e o diâmetro da artéria carótida comum direita foram determinados por ultrassom pulsátil tipo echotracking. A rigidez arterial foi medida por meio da velocidade das ondas de pulso. Todos os indivíduos responderam a um questionário estruturado e foram submetidos à avaliação periodontal. A sondagem periodontal dos dentes foi realizada em seis sítios por dente em cada paciente. Dados sobre inflamação gengival, presença de placa bacteriana, profundidade de sondagem, recessão gengival e perda de inserção clínica foram coletados. As variáveis contínuas foram comparadas pelo do teste t de Student não pareado ou teste de Mann-Whitney. Para as variáveis categóricas, foram aplicados os testes de qui-quadrado ou teste exato de Fisher. Resultados: Dos indivíduos do grupo controle, 32,3% apresentam quadro de periodontite grave, enquanto que no grupo caso, 64,1% apresentou esse quadro (p = 0,001). Nos grupos controle e caso, 19,4% contra 43,4% apresentam respectivamente mais que 15% de sítios com profundidade de sondagem > 4mm (p=0,02). Na análise intragrupo os indivíduos com periodontite avançada apresentaram valores mais elevados de espessura médio-intimal (p=0,04), velocidade de onda de pulso (p=0,04), proteína Creativa (p=0,02) e leucócitos séricos (p=0,04). Periodontite grave não foi associada com calcificação arterial coronariana. Conclusões: Periodontite grave, aterosclerose subclínica e elevados marcadores inflamatórios foram mais comumente observados nos indivíduos com hipercolesterolemia familiar / Introduction: Periodontitis is an inflammatory disease with consequent destruction of teeth supporting tissues. It has multifactorial etiology, and its main cause is accumulation of periodontal pathogens on the dental surface. Periodontitis has been associated with the advance of atherosclerosis. Familial hypercholesterolemia patients display premature development of atherosclerosis due to chronic exposure to high levels of total cholesterol and LDL-c. The association between subclinical atherosclerosis and periodontitis in this population has not been previously studied. Objective: This study analyzed the relation between coronary and/or carotid atherosclerosis and the periodontitis in patients with familial hypercholesterolemia. Methods: 82 individuals with familial hypercholesterolemia according to the U.S. MEDPED criteria (case group) and 31 healthy individuals (control group) were enrolled. Subclinical atherosclerosis was evaluated by three methods: coronary artery calcification, common carotid-artery intima and media thickness and the diameter of right common carotid artery, and arterial stiffness measured by aortic pulse wave velocity. All individuals answered a structured questionnaire and were submitted to a complete periodontal evaluation. Gingival inflammation, the presence of bacterial biofilm, probing depth, gingival recession and clinical attachment level were examined in six sites per tooth in each individual. Continuous variables were compared by Student t test or Mann-Whitney test. For categorical variables, Chisquare or Fisher exact test were applied. Results: In the control group, 32.3% showed advanced periodontitis, whereas in the case group, 64.1 % showed advanced periodontitis (p=0,001). In control and case groups, 19.4% versus 43.4% respectively showed more than 15 % of sites with probing depth > 4mm (p=0,02). Intra-group analysis revealed that both FH and healthy individuals showed positive association between advanced periodontitis and higher values of intima-media thickness (p=0.04), pulse wave velocity (p=0.04), C-reactive protein (p=0.02) and serum leukocytes (p=0.04). Advanced periodontitis was not associated with coronary artery calcification. Conclusions: Advanced periodontitis, subclinical atherosclerosis and elevated inflammatory markers were more frequently observed in FH individuals

by Choi Ka Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 113-128). / Abstract and appendix in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (Chinese version) --- p.iv / Table of Contents --- p.vi / List of Tables --- p.xi / List of Figures --- p.xiv / List of Abbreviations --- p.xv / Chapter CHAPTER ONE: --- BACKGROUND AND LITERATURE REVIEW / Chapter 1.1 --- Coronary Heart Disease: a global health problem --- p.1 / Chapter 1.2 --- Risk Factors of Coronary Heart Disease --- p.3 / Chapter 1.2.1 --- Age --- p.3 / Chapter 1.2.2 --- Gender --- p.4 / Chapter 1.2.3 --- Family History of Cardiovascular Disease --- p.5 / Chapter 1.2.4 --- Hypercholesterolemia --- p.7 / Chapter 1.2.5 --- Unhealthy Dietary Habits --- p.11 / Chapter 1.2.6 --- Obesity --- p.14 / Chapter 1.2.7 --- Physical Inactivity --- p.20 / Chapter 1.3 --- Clustering of Risk Factors --- p.24 / Chapter 1.4 --- Risk Factors in Children: Atherosclerosis Begins Early in Life --- p.26 / Chapter CHAPTER TWO: --- RESEARCH IN HONG KONG AND PURPOSES OF THIS STUDY / Chapter 2.1 --- Nutrition Transition --- p.27 / Chapter 2.2 --- CHD Mortality Trends in Hong Kong --- p.28 / Chapter 2.3 --- Serum Total Cholesterol and Obesity in Hong Kong Adults --- p.29 / Chapter 2.4 --- "Obesity, Serum Total Cholesterol, Dietary Habits and Physical Activity of Hong Kong Children and Adolescents" --- p.31 / Chapter 2.5 --- Study Purpose and Objectives --- p.35 / Chapter CHAPTER THREE: --- SURVEY DESIGN / Chapter 3.1 --- Sample Selection --- p.39 / Chapter 3.2 --- "Blood Total Blood Cholesterol, Triglyceride and Anthropometric Measurements" --- p.40 / Chapter 3.2.1 --- Total Blood Cholesterol and Triglyceride --- p.40 / Chapter 3.2.2 --- Anthropometry Measures --- p.42 / Chapter 3.3 --- Questionnaire --- p.45 / Chapter 3.3.1 --- Questionnaire Design and Pre-testing --- p.45 / Chapter 3.3.2 --- General Health and Socio-demographic Questionnaire --- p.47 / Chapter 3.3.3 --- Physical Activity Questionnaire --- p.47 / Chapter 3.3.4 --- Dietary Questionnaire --- p.48 / Chapter 3.4 --- Data Management --- p.49 / Chapter 3.5 --- Statistics --- p.49 / Chapter 3.6 --- Data Analysis --- p.50 / Chapter 3.6.1 --- Blood Total Cholesterol and Triglyceride --- p.50 / Chapter 3.6.2 --- Obesity and Fat Distribution --- p.50 / Chapter 3.6.3 --- Diet --- p.51 / Chapter 3.6.4 --- Physical Activity Patterns --- p.51 / Chapter 3.6.5 --- Body Mass Index of Parent and Family History of Diseases --- p.52 / Chapter CHAPTER FOUR: --- RESULTS / Chapter 4.1 --- Sample Size and the Characteristics of the Students in the Two Schools --- p.54 / Chapter 4.2 --- Gender and Age Distribution --- p.55 / Chapter 4.3 --- Blood Total Cholesterol and Triglyceride --- p.56 / Chapter 4.4 --- Anthropometry Measures --- p.58 / Chapter 4.5 --- Dietary Habits --- p.60 / Chapter 4.5.1 --- Dietary Composition of 3-day Dietary Record --- p.60 / Chapter 4.5.2 --- Eating Behaviors --- p.65 / Chapter 4.6 --- Physical Activity --- p.68 / Chapter 4.7 --- Family History of Diseases --- p.70 / Chapter 4.8 --- Parents' Anthropometry --- p.71 / Chapter 4.9 --- Demographic Data --- p.71 / Chapter 4.10 --- Inter-relationships --- p.75 / Chapter 4.10.1 --- Blood Total Cholesterol and Triglyceride --- p.75 / Chapter a. --- "Blood Total Cholesterol, Triglyceride and Body Fatness" --- p.75 / Chapter b. --- "Blood Total Cholesterol, Triglyceride and Diet" --- p.75 / Chapter c. --- "Blood Total Cholesterol, Triglyceride and Physical Activity Patterns" --- p.77 / Chapter d. --- Blood Total Cholesterol，Triglyceride and Family History of Hypercholesterolemia --- p.78 / Chapter e. --- Relative Importance of the Key Factors in Predicting Blood Total Cholesterol levels --- p.79 / Chapter 4.10.2 --- Obesity and Body Fatness --- p.79 / Chapter a. --- "Obesity, Body Fatness and Physical Activity Patterns" --- p.79 / Chapter b. --- "Obesity, Body Fatness and Diets" --- p.82 / Chapter c. --- Body Fatness and Genetics --- p.84 / Chapter 4.10.3 --- Diet and Physical Activity --- p.86 / Chapter 4.10.4 --- "Blood Total Cholesterol, Triglyceride, Obesity and Other Demographic or Economic Characteristics" --- p.87 / Chapter 4.11 --- Clustering of Risk Factors among Obese children --- p.87 / Chapter CHAPTER FIVE: --- DISCUSSION / Chapter 5.1 --- Implication of Research Findings --- p.89 / Chapter 5.2 --- Limitations --- p.108 / Chapter CHAPTER SIX: --- CONCLUSIONS AND RECOMMENDATIONS --- p.111 / References --- p.113 / Appendices / Chapter I --- Questionnaire (English version) --- p.129 / Chapter II --- Questionnaire (Chinese version) --- p.139 / Chapter III --- Introductory letter (English version) --- p.152 / Chapter V --- Introductory letter (Chinese version) --- p.153 / Chapter V --- Consent form (English version) --- p.154 / Chapter VI --- Consent form (Chinese version) --- p.155 / Chapter VII --- Photos of the standard household measures given to children for estimation of portion size (English version) --- p.156 / Chapter VIII --- Photos of the standard household measures given to children for estimation of portion size (Chinese version) --- p.157 / Chapter IX --- Responses from the children to the food frequency questionnaire --- p.158 / Chapter X --- The frequency of the reported food items liked or disliked by the children --- p.160

Introdução: A periodontite é uma doença inflamatória caracterizada clinicamente pela destruição dos tecidos de suporte dental. Apresenta etiologia multifatorial, sendo a principal causa o acúmulo de bactérias patogênicas na superfície dentária. A periodontite tem sido associada ao avanço da aterosclerose. Os indivíduos portadores da hipercolesterolemia familiar apresentam o desenvolvimento precoce da doença aterosclerótica devido à exposição crônica a níveis altos de colesterol total e LDL-colesterol. Não existem estudos que analisem a associação entre a infecção periodontal e aterosclerose subclínica nessa população. Objetivo: Este trabalho analisou a relação entre a aterosclerose, coronariana, carotídea e/ou aórtica, e a doença periodontal em indivíduos com hipercolesterolemia familiar e em controles presumidamente sem a doença. Métodos: Foram incluídos 82 indivíduos com diagnóstico de hipercolesterolemia familiar pelo critério do U.S. MEDPED e 31 indivíduos saudáveis como grupo controle. A calcificação arterial coronariana foi avaliada por tomografia computadorizada e a medida realizada pelo método de Agatston. O espessamento médio-intimal carotídeo e o diâmetro da artéria carótida comum direita foram determinados por ultrassom pulsátil tipo echotracking. A rigidez arterial foi medida por meio da velocidade das ondas de pulso. Todos os indivíduos responderam a um questionário estruturado e foram submetidos à avaliação periodontal. A sondagem periodontal dos dentes foi realizada em seis sítios por dente em cada paciente. Dados sobre inflamação gengival, presença de placa bacteriana, profundidade de sondagem, recessão gengival e perda de inserção clínica foram coletados. As variáveis contínuas foram comparadas pelo do teste t de Student não pareado ou teste de Mann-Whitney. Para as variáveis categóricas, foram aplicados os testes de qui-quadrado ou teste exato de Fisher. Resultados: Dos indivíduos do grupo controle, 32,3% apresentam quadro de periodontite grave, enquanto que no grupo caso, 64,1% apresentou esse quadro (p = 0,001). Nos grupos controle e caso, 19,4% contra 43,4% apresentam respectivamente mais que 15% de sítios com profundidade de sondagem > 4mm (p=0,02). Na análise intragrupo os indivíduos com periodontite avançada apresentaram valores mais elevados de espessura médio-intimal (p=0,04), velocidade de onda de pulso (p=0,04), proteína Creativa (p=0,02) e leucócitos séricos (p=0,04). Periodontite grave não foi associada com calcificação arterial coronariana. Conclusões: Periodontite grave, aterosclerose subclínica e elevados marcadores inflamatórios foram mais comumente observados nos indivíduos com hipercolesterolemia familiar / Introduction: Periodontitis is an inflammatory disease with consequent destruction of teeth supporting tissues. It has multifactorial etiology, and its main cause is accumulation of periodontal pathogens on the dental surface. Periodontitis has been associated with the advance of atherosclerosis. Familial hypercholesterolemia patients display premature development of atherosclerosis due to chronic exposure to high levels of total cholesterol and LDL-c. The association between subclinical atherosclerosis and periodontitis in this population has not been previously studied. Objective: This study analyzed the relation between coronary and/or carotid atherosclerosis and the periodontitis in patients with familial hypercholesterolemia. Methods: 82 individuals with familial hypercholesterolemia according to the U.S. MEDPED criteria (case group) and 31 healthy individuals (control group) were enrolled. Subclinical atherosclerosis was evaluated by three methods: coronary artery calcification, common carotid-artery intima and media thickness and the diameter of right common carotid artery, and arterial stiffness measured by aortic pulse wave velocity. All individuals answered a structured questionnaire and were submitted to a complete periodontal evaluation. Gingival inflammation, the presence of bacterial biofilm, probing depth, gingival recession and clinical attachment level were examined in six sites per tooth in each individual. Continuous variables were compared by Student t test or Mann-Whitney test. For categorical variables, Chisquare or Fisher exact test were applied. Results: In the control group, 32.3% showed advanced periodontitis, whereas in the case group, 64.1 % showed advanced periodontitis (p=0,001). In control and case groups, 19.4% versus 43.4% respectively showed more than 15 % of sites with probing depth > 4mm (p=0,02). Intra-group analysis revealed that both FH and healthy individuals showed positive association between advanced periodontitis and higher values of intima-media thickness (p=0.04), pulse wave velocity (p=0.04), C-reactive protein (p=0.02) and serum leukocytes (p=0.04). Advanced periodontitis was not associated with coronary artery calcification. Conclusions: Advanced periodontitis, subclinical atherosclerosis and elevated inflammatory markers were more frequently observed in FH individuals