Sanghvi Mihir M, Ramírez Julia, Chadalavada Sucharitha, Aung Nay, Munroe Patricia B, Donos Nikolaos, Petersen Steffen E
William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.
Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom.
JACC Adv. 2024 Aug 31;3(10):101241. doi: 10.1016/j.jacadv.2024.101241. eCollection 2024 Oct.
Periodontal disease is the sixth most common disease worldwide and may be a contributory risk factor for cardiovascular disease (CVD).
This study utilizes noninvasive cardiac imaging and longitudinal and genetic data to characterize the association between periodontal disease and both cardiovascular magnetic resonance (CMR) imaging biomarkers of remodeling and incident coronary artery disease (CAD).
From the UK Biobank, 481,915 individuals were included, 91,022 (18.9%) of whom had self-reported periodontal disease. For imaging analysis, 59,019 had paired CMR data. Multivariable linear regression models were constructed to examine the association of periodontal disease on CMR outcomes. The endpoints for the CMR analyses were left ventricle (LV) end-diastolic volume, LV ejection fraction, LV mass, LV mass:volume ratio, LV global longitudinal strain, and native T1 values. The relationship between periodontal disease and CVD was assessed using Cox proportional hazards regression models, with incident CAD as the endpoint. To examine the relationship of genetically determined periodontal disease on CAD, a genome-wide polygenic risk score was constructed.
Periodontal disease was associated with a significantly higher LV mass:volume ratio (effect size: 0.00233; 95% CI: 0.0006-0.004) and significantly lower T1 values (effect size: -0.86 ms; 95% CI: -1.63 to -0.09). Periodontal disease was independently associated with an increased hazard of incident CAD (HR: 1.09; 95% CI: 1.07-1.13) at a median follow-up time of 13.8 years. Each SD increase in the periodontal disease polygenic risk score was associated with increased odds of CAD (OR: 1.03; 95% CI: 1.02-1.05).
Using an integrated approach across imaging, observational, and genomic data, periodontal disease is associated with biomarkers of subclinical remodeling as well as incident CAD. These findings highlight the potential importance of periodontal disease in the broader context of CVD prevention.
牙周病是全球第六大常见疾病，可能是心血管疾病（CVD）的一个促成风险因素。
本研究利用非侵入性心脏成像以及纵向和基因数据，来描述牙周病与心血管磁共振（CMR）成像的重塑生物标志物和冠心病（CAD）发病之间的关联。
从英国生物银行纳入了481,915名个体，其中91,022名（18.9%）自我报告患有牙周病。对于成像分析，59,019名有配对的CMR数据。构建多变量线性回归模型来检验牙周病与CMR结果之间的关联。CMR分析的终点是左心室（LV）舒张末期容积、LV射血分数、LV质量、LV质量：容积比、LV整体纵向应变和固有T1值。使用Cox比例风险回归模型评估牙周病与CVD之间的关系，以CAD发病作为终点。为了检验基因决定的牙周病与CAD之间的关系，构建了全基因组多基因风险评分。
牙周病与显著更高的LV质量：容积比（效应大小：0.00233；95%CI：0.0006 - 0.004）和显著更低的T1值（效应大小：-0.86毫秒；95%CI：-1.63至-0.09）相关。在中位随访时间13.8年时，牙周病与CAD发病风险增加独立相关（HR：1.09；95%CI：1.07 - 1.13）。牙周病多基因风险评分每增加一个标准差与CAD发病几率增加相关（OR：1.03；95%CI：1.02 - 1.05）。
通过综合运用成像、观察性和基因组数据的方法，牙周病与亚临床重塑生物标志物以及CAD发病相关。这些发现突出了牙周病在更广泛的CVD预防背景下的潜在重要性。
