龋齿是脑出血的一个危险因素。
Dental Caries a Risk Factor for Intracerebral Hemorrhage.
机构信息
Department of Neurology, University of South Carolina, School of Medicine, Columbia, South Carolina, USA.
Department of Neurology, Regional Medical Center, Orangeburg, South Carolina, USA.
出版信息
Cerebrovasc Dis. 2024;53(1):98-104. doi: 10.1159/000530568. Epub 2023 May 9.
INTRODUCTION
Streptococcus mutans is a known cause of dental caries that contains a collagen-binding protein, Cnm, and exhibits inhibition of platelet aggregation and matrix metalloproteinase-9 activation. This strain has been linked to aggravation of experimental intracerebral hemorrhage (ICH) and may be a risk factor for ICH. The purpose of this study was to test the association between dental caries and incident ICH.
METHODS
The presence of dental caries and periodontal disease was assessed in subjects from the Dental Atherosclerosis Risk in Communities (DARIC) study without prior stroke or ICH. This cohort was followed for incident ICH over a period of 10 years. Cox regression was used to compute crude and adjusted hazards ratio from the dental assessment.
RESULTS
Among 6,315 subjects, dental surface caries and/or root caries were recorded in 1,338 (27%) subjects. Of those, 7 (0.5%) had incident ICH over a period of 10 years following the visit 4 assessment. Of the remaining 4,977 subjects, 10 (0.2%) had incident ICH. Those with dental caries versus those without dental caries were slightly younger (mean age 62.0 ± 5.7 vs. 62.4 ± 5.6, p = 0.012), had a greater proportion of males (51 vs. 44%, p < 0.001), African Americans (44 vs. 10%, p < 0.001), and were hypertensive (42 vs. 31%, p < 0.001). The association between caries and ICH was significant (crude HR 2.69, 95% CI 1.02-7.06) and strengthened after adjustment for age, gender, race, education level, hypertension, and periodontal disease (adjusted HR 3.88, 95% CI 1.34-11.24).
CONCLUSION
Dental caries is a potential risk for incident ICH after caries detection. Future studies are needed to determine if treatment of dental caries can reduce the risk of ICH.
简介
变形链球菌是导致龋齿的已知原因，它含有一种胶原蛋白结合蛋白 Cnm，并具有抑制血小板聚集和基质金属蛋白酶-9 激活的作用。这种菌株与实验性脑出血（ICH）的恶化有关，可能是 ICH 的一个危险因素。本研究旨在检验龋齿与脑出血事件之间的相关性。
方法
在没有先前中风或 ICH 的社区牙科动脉粥样硬化风险（DARIC）研究的受试者中评估龋齿和牙周病的存在情况。该队列在 10 年内对脑出血事件进行了随访。Cox 回归用于根据牙科评估计算出未调整和调整后的危险比。
结果
在 6315 名受试者中，1338 名（27%）受试者有牙齿表面龋齿和/或根面龋齿。其中，7 名（0.5%）在随访 4 评估后的 10 年内发生脑出血事件。在其余 4977 名受试者中，有 10 名（0.2%）发生脑出血事件。与无龋齿者相比，有龋齿者年龄稍小（平均年龄 62.0 ± 5.7 岁比 62.4 ± 5.6 岁，p = 0.012），男性比例更高（51%比 44%，p < 0.001），非裔美国人比例更高（44%比 10%，p < 0.001），高血压比例更高（42%比 31%，p < 0.001）。龋齿与脑出血之间的关联具有显著性（未调整的 HR 2.69，95%CI 1.02-7.06），且在调整年龄、性别、种族、教育水平、高血压和牙周病后关联增强（调整的 HR 3.88，95%CI 1.34-11.24）。
结论
在检测到龋齿后，龋齿是脑出血事件的潜在风险因素。需要进一步研究来确定治疗龋齿是否可以降低脑出血的风险。
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