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牙周炎患者心血管疾病的危险因素。

Risk factors for cardiovascular disease in patients with periodontitis.

作者信息

Buhlin Kåre, Gustafsson Anders, Pockley A Graham, Frostegård Johan, Klinge Björn

机构信息

Department of Periodontology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden.

出版信息

Eur Heart J. 2003 Dec;24(23):2099-107. doi: 10.1016/j.ehj.2003.09.016.

DOI:10.1016/j.ehj.2003.09.016
PMID:14643270
Abstract

AIMS

This study compared plasma levels of established risk markers for atherosclerosis and indices of inflammation in 50 patients with severe periodontitis to those in 46 healthy cases.

METHODS AND RESULTS

Full blood counts were performed and levels of high density lipoproteins (HDL), total cholesterol, haptoglobin, elastase, C-reactive protein (CRP), IL-6, TNFalpha receptor-1, alpha-1-antitrypsin and antibodies against human heat shock protein (Hsp) 60, mycobacterial Hsp65 and oxLDL were determined. Total cholesterol levels were similar in both groups, whereas HDL levels were lower (P=0.007) and the lipid profile (total cholesterol/HDL) was consequentially higher (P=0.03) in patients. Monocyte counts were elevated (0.56 vs 0.44x10(9)/l; P=0.002) and CRP levels were higher in patients, but TNFalpha receptor-1 and elastase levels were not. Anti-oxLDL antibody levels were similar, as were levels of haptoglobin, IgG anti HSP60, IgA and IgG anti-Hsp65 antibodies. Levels of IgA anti-Hsp60 antibodies were lower in patients (P=0.0001). Logistic regression analysis revealed a relationship between periodontitis and HDL (OR 2.15/0.5mmol/l, P=0.02) and body mass index (OR 4.54 P=0.005).

CONCLUSIONS

Serological differences in subjects with periodontitis, some of which involve established risk factors for atherosclerosis, might provide insight into the reported epidemiological association between periodontitis and cardiovascular disease.

摘要

目的

本研究比较了50例重度牙周炎患者与46例健康对照者的动脉粥样硬化既定风险标志物的血浆水平及炎症指标。

方法与结果

进行全血细胞计数,并测定高密度脂蛋白(HDL)、总胆固醇、触珠蛋白、弹性蛋白酶、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α受体-1、α-1抗胰蛋白酶以及抗人热休克蛋白(Hsp)60、分枝杆菌Hsp65和氧化型低密度脂蛋白(oxLDL)抗体的水平。两组的总胆固醇水平相似,而患者的HDL水平较低(P = 0.007),因此血脂谱(总胆固醇/HDL)较高(P = 0.03)。患者的单核细胞计数升高(0.56对0.44×10⁹/L;P = 0.002),CRP水平较高,但肿瘤坏死因子α受体-1和弹性蛋白酶水平无差异。抗oxLDL抗体水平相似,触珠蛋白、抗Hsp60 IgG、IgA和抗Hsp65 IgG抗体水平也相似。患者的抗Hsp60 IgA抗体水平较低(P = 0.0001)。逻辑回归分析显示牙周炎与HDL(比值比2.15/0.5mmol/L,P = 0.02)和体重指数(比值比4.54,P = 0.005)之间存在关联。

结论

牙周炎患者的血清学差异,其中一些涉及动脉粥样硬化的既定风险因素,可能有助于深入了解牙周炎与心血管疾病之间已报道的流行病学关联。

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