Gocke Christiane, Holtfreter Birte, Meisel Peter, Grotevendt Anne, Jablonowski Lukasz, Nauck Matthias, Markus Marcello Ricardo Paulista, Kocher Thomas
Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
Atherosclerosis. 2014 Aug;235(2):351-7. doi: 10.1016/j.atherosclerosis.2014.05.926. Epub 2014 May 22.
Periodontitis is considered to promote atherosclerosis and cardiovascular diseases through increased low-grade systemic inflammation. However, there is no information on the long-term impact of periodontitis on systemic inflammation from cohort studies. Thus, this study aims to assess the impact of periodontitis on systemic inflammation (fibrinogen and white blood cells (WBC)) in a population-based longitudinal survey in north-eastern Germany.
The study sample comprised 2622 subjects from the Study of Health in Pomerania with complete 5- and 11-year follow-ups. Periodontitis was assessed by probing depth and clinical attachment level. Multilevel regression analyses were applied to evaluate associations between periodontitis measures and i) fibrinogen/WBC count using 11-year follow-up data and ii) respective z-scores of fibrinogen/WBC count using 5- and 11-year follow-up data. We adjusted for common cardiovascular risk factors and stratified analyses by abdominal obesity (P for interaction <0.10).
In lean subjects, beta-coefficients of mean probing depth were B = 0.13 (0.08-0.019; P < 0.001) for fibrinogen and B = 0.50 (0.37-0.64; P < 0.001) for WBC count using 11-year follow-up data only. For lean subjects, models using z-scores confirmed that increased mean probing depths were associated with increased fibrinogen z-scores (B = 0.14 (0.09-0.18; P < 0.001)) and increased WBC z-scores (B = 0.16 (0.11-0.20; P < 0.001)). Consistent results were found for mean clinical attachment levels. For abdominally obese subjects, relations between periodontitis measures and levels of inflammation markers were less pronounced or non-significant.
Modified by abdominal obesity, periodontitis affected systemic inflammation in a significant dose-dependent manner. Results contribute to the discussion on how periodontitis is linked to atherosclerosis and cardiovascular diseases.
牙周炎被认为可通过加剧低度全身炎症来促进动脉粥样硬化和心血管疾病。然而，队列研究中尚无关于牙周炎对全身炎症长期影响的相关信息。因此，本研究旨在通过德国东北部一项基于人群的纵向调查，评估牙周炎对全身炎症（纤维蛋白原和白细胞（WBC））的影响。
研究样本包括来自波美拉尼亚健康研究的2622名受试者，他们均有完整的5年和11年随访数据。通过探诊深度和临床附着水平评估牙周炎。采用多水平回归分析来评估牙周炎指标与以下两项之间的关联：i）使用11年随访数据的纤维蛋白原/白细胞计数；ii）使用5年和11年随访数据的纤维蛋白原/白细胞计数的相应z分数。我们对常见的心血管危险因素进行了校正，并按腹型肥胖进行分层分析（交互作用P<0.10）。
在体型偏瘦的受试者中，仅使用11年随访数据时，平均探诊深度的β系数对于纤维蛋白原为B = 0.13（0.08 - 0.19；P < 0.001），对于白细胞计数为B = 0.50（0.37 - 0.64；P < 0.001）。对于体型偏瘦的受试者，使用z分数的模型证实，平均探诊深度增加与纤维蛋白原z分数增加（B = 0.14（0.09 - 0.18；P < 0.001））和白细胞z分数增加（B = 0.16（0.11 - 0.20；P < 0.001））相关。平均临床附着水平也得到了一致的结果。对于腹型肥胖的受试者，牙周炎指标与炎症标志物水平之间的关系不太明显或无统计学意义。
受腹型肥胖影响，牙周炎以显著的剂量依赖方式影响全身炎症。研究结果有助于探讨牙周炎与动脉粥样硬化和心血管疾病之间的联系。
