Lafon Arnaud, Tala Stéphane, Ahossi Victorin, Perrin Daniel, Giroud Maurice, Béjot Yannick
University of Champagne-Ardenne , Reims Cedex , France.
Acta Odontol Scand. 2014 Nov;72(8):687-93. doi: 10.3109/00016357.2014.898089. Epub 2014 Apr 11.
This study aimed to investigate the association between clinical and radiological markers of periodontal disease and ischemic stroke and to assess the potential influence of inflammatory response on the observed associations.
A prospective case-control study including a series of 48 cases with a minor ischemic stroke and 47 controls was conducted at the University Hospital of Dijon. Vascular risk factors, clinical dental examination (plaque index, gingival index, percentage of pockets >5 mm, percentage of bleeding on probing (BOP) sites), dental panoramic (bone loss) and biological parameters (CRP, total cholesterol, HDL, LDL, fasting glucose) were collected. Conditional regression analyses were performed to identify factors associated with ischemic stroke.
The prevalence of hypertension, high CRP and glucose levels and overall odontological variables was higher in stroke patients. In multivariable analyses, hypertension (OR = 12.56; 95% CI = 2.29-69.96, p = 0.004), CRP levels >5 mg/L (OR = 18.54; 95% CI = 2.01-171.17, p = 0.010), BOP (OR = 1.049; 95% CI = 1.012-1.88, p = 0.009) and bone loss >20% (OR = 1.053; 95% CI = 1.017-1.091, p = 0.004) were associated with ischemic stroke. Among stroke patients, there was a non-significant trend towards higher CRP levels in patients with bone loss >20% compared with those with bone loss <20% (8.1 ± 1.27 mg/L vs 3.12 ± 3.14 mg/L, p = 0.25), whereas other biological parameters were very similar between the two groups.
This case-control study demonstrates that periodontal disease, especially markers such as BOP and bone loss, is independently associated with ischemic stroke.
本研究旨在调查牙周病的临床和放射学标志物与缺血性中风之间的关联，并评估炎症反应对所观察到的关联的潜在影响。
在第戎大学医院进行了一项前瞻性病例对照研究，纳入了48例轻度缺血性中风患者和47例对照。收集血管危险因素、临床牙科检查（菌斑指数、牙龈指数、深度>5mm的牙周袋百分比、探诊出血（BOP）部位百分比）、牙科全景片（骨质流失）和生物学参数（CRP、总胆固醇、高密度脂蛋白、低密度脂蛋白、空腹血糖）。进行条件回归分析以确定与缺血性中风相关的因素。
中风患者中高血压、高CRP和血糖水平以及总体牙科学变量的患病率更高。在多变量分析中，高血压（OR = 12.56；95%CI = 2.29 - 69.96，p = 0.004）、CRP水平>5mg/L（OR = 18.54；95%CI = 2.01 - 171.17，p = 0.010）、BOP（OR = 1.049；95%CI = 1.012 - 1.88，p = 0.009）和骨质流失>20%（OR = 1.053；95%CI = 1.017 - 1.091，p = 0.004）与缺血性中风相关。在中风患者中，骨质流失>20%的患者与骨质流失<20%的患者相比，CRP水平有升高的非显著趋势（8.1±1.27mg/L对3.12±3.1mg/L，p = ），而两组间其他生物学参数非常相似。
这项病例对照研究表明，牙周病，尤其是BOP和骨质流失等标志物，与缺血性中风独立相关。
