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成人牙周炎与动脉粥样硬化之间是否存在关联?系统评价。

Is there an Association Between Periodontitis and Atherosclerosis in Adults? A Systematic Review.

机构信息

Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Belem, Brazil.

Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Curr Vasc Pharmacol. 2018;16(6):569-582. doi: 10.2174/1570161115666170830141852.

Abstract

BACKGROUND

Atherosclerosis is a multifactorial inflammatory disease of the cardiovascular system. It has been suggested that periodontitis, an infectious disease of oral cavity caused by gramnegative anaerobic bacteria, could be linked to atherosclerosis.

OBJECTIVE

The objective of this systematic review was to assess the evidence between the association of periodontitis and atherosclerosis in adults.

METHODS

A systematic literature search was conducted in 7 databases up to January 2017, according to the Preferential Reports for Systematic Review and Meta-analysis (PRISMA) guidelines. Studies in humans with atherosclerosis were considered eligible when considering a group exposed to periodontitis and a control group (absence of periodontitis), in which the primary outcome was the association between the 2 diseases (atherosclerosis and periodontitis). The synthesis of the qualitative studies included was evaluated using previously validated checklist for assessing the risk of bias.

RESULTS

Among the 2138 studies found, 4 observational studies met the eligibility criteria and were included in the qualitative synthesis. All articles were considered adequate, presenting consistent and valid information. The results of the selected studies show the expected effects, being considered as low risk of bias.

CONCLUSION

The available evidence indicates an association between the 2 diseases, with elevated levels of inflammatory markers, mainly C-reactive protein and interleukin 6.

摘要

背景

动脉粥样硬化是心血管系统的一种多因素炎症性疾病。有人认为,牙周炎是一种由革兰氏阴性厌氧菌引起的口腔感染性疾病,可能与动脉粥样硬化有关。

目的

本系统评价的目的是评估牙周炎与成人动脉粥样硬化之间关联的证据。

方法

根据系统评价和荟萃分析的首选报告(PRISMA)指南,我们在 7 个数据库中进行了系统文献检索。当考虑一组暴露于牙周炎和对照组(无牙周炎)的人群时,考虑患有动脉粥样硬化的人类研究是合格的,其中主要结局是这两种疾病(动脉粥样硬化和牙周炎)之间的关联。定性研究的综合评价使用了以前验证过的评估偏倚风险检查表进行评估。

结果

在发现的 2138 项研究中,有 4 项观察性研究符合纳入标准,并纳入了定性综合分析。所有文章均被认为是充分的,提供了一致和有效的信息。所选研究的结果显示出预期的效果,被认为是低偏倚风险。

结论

现有证据表明这两种疾病之间存在关联,炎症标志物水平升高,主要是 C 反应蛋白和白细胞介素 6。

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