Söder P-O, Meurman J H, Jogestrand T, Nowak J, Söder B
Institute of Odontology, Karolinska Institute, Huddinge, Sweden.
J Periodontal Res. 2009 Aug;44(4):452-8. doi: 10.1111/j.1600-0765.2008.01145.x. Epub 2008 Oct 22.
An association has been found between periodontal disease and the development of atherosclerosis. We investigated the hypothesis that periodontal disease triggers the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in blood. Increased levels of these parameters might then indicate early atherosclerosis.
In this cross-sectional study, the material comprised 80 subjects with chronic periodontitis and 31 subjects with no periodontal disease. Sixteen years after diagnosis of periodontal disease ultrasonography revealed a statistically significant difference (p < 0.001) of carotid intima-media thickness between the subjects with chronic periodontitis and the periodontally healthy subjects. Matrix metalloproteinase-9 and TIMP-1 were analyzed from blood as periodontal and systemic inflammatory markers. The relationship between MMP-9, TIMP-1 and MMP-9/TIMP-1 as dependent variables and several independent variables (age, sex, smoking, education, body mass index, hypertension, periodontal disease and cholesterol) were analyzed in multiple logistic regression models to assess the value of the inflammatory markers in predicting carotid atherosclerosis.
Matrix metalloproteinase-9 and TIMP-1 were significantly higher in plasma from subjects with periodontal disease and atherosclerosis. Periodontal disease was identified as the principal independent predictor both for atherosclerosis (odds ratio 3.89 for increase in bilateral carotid intima-media thickness) and for increased MMP-9, TIMP-1 and MMP-9/TIMP-1 (odds ratio 2.58, 5.53 and 3.41, respectively). Classical atherosclerosis risk factors, such as increased total cholesterol, age and sex (women), were significant predictors in the model.
Matrix metalloproteinase-9, TIMP-1 and MMP-9/TIMP-1 in blood from subjects with periodontal disease could be useful laboratory markers for increased carotid artery intima-media thickness.
已发现牙周病与动脉粥样硬化的发生之间存在关联。我们研究了牙周病触发血液中基质金属蛋白酶-9（MMP-9）和基质金属蛋白酶组织抑制因子-1（TIMP-1）表达的假说。这些参数水平的升高可能预示早期动脉粥样硬化。
在这项横断面研究中，材料包括80例慢性牙周炎患者和31例无牙周病患者。牙周病诊断16年后，超声检查显示慢性牙周炎患者与牙周健康患者的颈动脉内膜中层厚度存在统计学显著差异（p < 0.001）。分析血液中的基质金属蛋白酶-9和TIMP-1作为牙周和全身炎症标志物。在多元逻辑回归模型中分析MMP-9、TIMP-1和MMP-9/TIMP-1作为因变量与几个自变量（年龄、性别、吸烟、教育程度、体重指数、高血压、牙周病和胆固醇）之间的关系，以评估炎症标志物在预测颈动脉粥样硬化中的价值。
牙周病和动脉粥样硬化患者血浆中的基质金属蛋白酶-9和TIMP-1显著更高。牙周病被确定为动脉粥样硬化（双侧颈动脉内膜中层厚度增加的优势比为3.89）以及MMP-9、TIMP-1和MMP-9/TIMP-1升高（优势比分别为2.58、5.53和3.41）的主要独立预测因素。经典的动脉粥样硬化危险因素，如总胆固醇升高、年龄和性别（女性），是该模型中的显著预测因素。
牙周病患者血液中的基质金属蛋白酶-9、TIMP-1和MMP-9/TIMP-1可能是颈动脉内膜中层厚度增加的有用实验室标志物。
