Söder Per-Osten, Söder Birgitta, Nowak Jacek, Jogestrand Tomas
Institution of Odontology, Karolinska Institutet, Box 4064 141 04, Huddinge, Sweden.
Stroke. 2005 Jun;36(6):1195-200. doi: 10.1161/01.STR.0000165916.90593.cb. Epub 2005 May 5.
There is growing experimental evidence implicating chronic inflammation/infection as an atherosclerotic risk factor. In this study, the involvement of periodontal disease in the development of early atherosclerotic vascular lesions has been evaluated.
In randomly chosen 82 patients with periodontal disease and 31 periodontally healthy individuals subjected to a clinical oral examination in 1985, atherosclerotic risk factor analysis and carotid ultrasonography was performed during reexamination 16 years later. Common carotid artery intima-media thickness (IMT) and lumen diameter were measured and intima-media area (cIMA) was calculated. The relationship between IMT and cIMA as dependent variables and periodontal disease, age, gender, body mass index, heredity for atherosclerosis, diabetes mellitus, hypertension, plasma cholesterol, smoking, and education as independent variables was evaluated in a multiple logistic regression model.
The mean values of IMT and cIMA were significantly higher in patients with periodontal disease than in controls, both at the right (P<0.01 and P<0.001, respectively) and left side (P<0.001 for both variables). When the means of the bilateral measurements of these 2 ultrasonographic variables were tested, multiple logistic regression analysis identified periodontal disease as a principal independent predictor of the common carotid artery cIMA (odds ratio [OR], 5.20; P=0.003) and IMT (OR, 4.64; P=0.004).
The present results indicate that periodontal disease is associated with the development of early atherosclerotic carotid lesions.
越来越多的实验证据表明，慢性炎症/感染是动脉粥样硬化的一个危险因素。在本研究中，已对牙周疾病在早期动脉粥样硬化性血管病变发展中的作用进行了评估。
1985年随机选取82例牙周疾病患者和31例牙周健康个体进行临床口腔检查，16年后复查时进行动脉粥样硬化危险因素分析和颈动脉超声检查。测量颈总动脉内膜中层厚度（IMT）和管腔直径，并计算内膜中层面积（cIMA）。在多元逻辑回归模型中，评估作为因变量的IMT和cIMA与作为自变量的牙周疾病、年龄、性别、体重指数、动脉粥样硬化遗传因素、糖尿病、高血压、血浆胆固醇、吸烟和受教育程度之间的关系。
牙周疾病患者右侧（分别为P<0.01和P<0.001）和左侧（两个变量均为P<0.001）的IMT和cIMA平均值均显著高于对照组。当对这两个超声变量的双侧测量均值进行检验时，多元逻辑回归分析确定牙周疾病是颈总动脉cIMA（比值比[OR]，5.20；P=0.003）和IMT（OR，4.64；P=0.004）的主要独立预测因素。
目前的结果表明，牙周疾病与早期动脉粥样硬化性颈动脉病变的发展有关。
