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牙周病致病菌的诊断前血浆抗体水平与冠心病风险

Prediagnostic plasma antibody levels to periodontopathic bacteria and risk of coronary heart disease.

作者信息

Ueno Masayuki, Izumi Yuichi, Kawaguchi Yoko, Ikeda Ai, Iso Hiroyasu, Inoue Manami, Tsugane Shoichiro

机构信息

Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.

出版信息

Int Heart J. 2012;53(4):209-14. doi: 10.1536/ihj.53.209.

Abstract

Many epidemiological studies have indicated that periodontitis is an important risk factor for coronary heart disease (CHD). We examined whether plasma antibody levels to 3 major periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia predicted the risk of CHD events. A nested case-control research design (case: n = 191, control: n = 382), by matching gender, age, study area, date of blood collection, and time since last meal at blood collection, was employed in a large cohort of Japanese community residents.Antibody levels of periodontopathic bacteria were associated with risk of CHD after adjusting for BMI, smoking status, alcohol intake, history of hypertension, history of diabetes mellitus, exercise during leisure time, and perceived mental stress. The association was different by age subgroup. For subjects aged 40-55 years, the medium (31.7-184.9 U/mL) or high tertile plasma antibody level (> 184.9 U/mL) of A. actinomycetemcomitans showed higher risk of CHD (medium: OR = 3.72; 95% CI = 1.20-11.56, high: OR = 4.64; 95% CI = 1.52-14.18) than the low tertile level (< 31.7 U/mL). The ORs of CHD incidence became higher with an increase in IgG level of A. actinomycetemcomitans (P for trend = 0.007). For subjects aged 56-69 years, the high tertile level (> 414.1 U/mL) of P. intermedia was associated with higher risk of CHD (OR = 2.65; 95% CI = 1.18-5.94) in a dose-response fashion (P for trend = 0.007). The possible role of periodontopathic bacteria as a risk factor for CHD incidence was suggested by the results of this study by the elevated antibody level to these bacteria with the increased risk of CHD.

摘要

许多流行病学研究表明,牙周炎是冠心病(CHD)的一个重要危险因素。我们研究了针对3种主要牙周病原体——伴放线聚集杆菌、牙龈卟啉单胞菌和中间普氏菌的血浆抗体水平是否能预测冠心病事件的风险。在一大群日本社区居民中采用了巢式病例对照研究设计(病例:n = 191,对照:n = 382),通过匹配性别、年龄、研究区域、采血日期以及采血时距上次进餐的时间。在调整了体重指数、吸烟状况、饮酒量、高血压病史、糖尿病病史、休闲时间运动情况以及感知到的精神压力后,牙周病原菌的抗体水平与冠心病风险相关。这种关联在不同年龄亚组中有所不同。对于40 - 55岁的受试者,伴放线聚集杆菌的中等(31.7 - 184.9 U/mL)或高三分位血浆抗体水平(> 184.9 U/mL)显示出比低三分位水平(< 31.7 U/mL)更高的冠心病风险(中等:OR = 3.72;95% CI = 1.20 - 11.56,高:OR = 4.64;95% CI = 1.52 - 14.18)。伴放线聚集杆菌的IgG水平升高,冠心病发病率的OR值也随之升高(趋势P值 = 0.007)。对于56 - 69岁的受试者,中间普氏菌的高三分位水平(> 414.1 U/mL)以剂量反应方式与更高的冠心病风险相关(OR = 2.65;95% CI = 1.18 - 5.94)(趋势P值 = 0.007)。这项研究的结果表明,随着冠心病风险增加,针对这些细菌的抗体水平升高,牙周病原菌可能作为冠心病发病的一个危险因素。

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