Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.
J Periodontol. 2010 May;81(5):658-65. doi: 10.1902/jop.2010.090614.
Several studies suggested that periodontitis is a risk factor for stroke, but the relationship between periodontitis and hemorrhagic stroke has not been widely reported. This study aims to evaluate the association between periodontitis and hemorrhagic stroke and to identify the risk group for this association.
We recruited 165 patients who were diagnosed via computed tomography brain imaging as having had a hemorrhagic stroke and 214 non-stroke control subjects for a case-control study. All participants underwent a clinical periodontal examination using clinical attachment level (CAL) as a marker. Information about sociodemographic factors, behavioral factors, systemic health, and a familial history of systemic health was gathered through an interview using structured questionnaires. The association between periodontitis and hemorrhagic stroke was evaluated using multivariate logistic regression analyses with adjustment for age, gender, income, education, hypertension, diabetes, body mass index, cardiac disease, familial hypertension history, familial diabetes history, familial cardiac disease history, smoking, and alcohol consumption. Subgroup analyses were also performed to investigate potential risk groups.
After controlling for potential confounders, periodontitis (CAL > or =6 mm) was found to be significantly associated with hemorrhagic stroke (odds ratio: 2.5; 95% confidence interval: 1.1 to 5.6), but this association did not exhibit a dose-dependent response for periodontitis (percentile of sites of periodontal pockets with CAL > or =5 mm among total probed pockets). The association between periodontitis (CAL > or =6 mm) and hemorrhagic stroke was significant for males, patients who had a lower income than control subjects, obese patients, and patients without diabetes.
Periodontitis may be an independent risk factor for hemorrhagic stroke. Risk groups include males, patients without diabetes, and obese subjects.
多项研究表明牙周炎是中风的一个危险因素，但牙周炎与出血性中风之间的关系尚未得到广泛报道。本研究旨在评估牙周炎与出血性中风之间的关系，并确定该关联的风险群体。
我们进行了一项病例对照研究，共纳入 165 名经计算机断层扫描脑成像诊断为出血性中风的患者和 214 名非中风对照者。所有参与者均接受了临床牙周检查，以临床附着水平（CAL）作为标志物。通过使用结构化问卷进行的访谈，收集了社会人口统计学因素、行为因素、全身健康状况以及全身健康家族史等信息。使用多变量逻辑回归分析，在校正年龄、性别、收入、教育程度、高血压、糖尿病、体重指数、心脏病、家族高血压病史、家族糖尿病病史、家族心脏病病史、吸烟和饮酒等因素后，评估了牙周炎与出血性中风之间的关系。还进行了亚组分析，以探讨潜在的风险群体。
在控制了潜在的混杂因素后，发现牙周炎（CAL≥6mm）与出血性中风显著相关（比值比：2.5；95%置信区间：1.1 至 5.6），但牙周炎（总探查袋中 CAL≥5mm 的牙周袋百分率）与出血性中风之间不存在剂量依赖性关系。牙周炎（CAL≥6mm）与出血性中风之间的关联在男性、收入低于对照组的患者、肥胖患者和无糖尿病患者中具有统计学意义。
牙周炎可能是出血性中风的一个独立危险因素。风险群体包括男性、无糖尿病患者和肥胖人群。
