Antibodies to periodontal pathogens and stroke risk
Antibodies to periodontal pathogens and stroke risk
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DOI：
10.1161/01.str.0000136148.29490.fe
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发表时间：
2004-09-01
期刊：
影响因子：
8.3
通讯作者：
Knekt, P
中科院分区：
文献类型：
--
作者：
Pussinen, PJ;Alfthan, G;Knekt, P
背景和目的-脑血管事件和牙周炎之间的联系在基于临床牙周检查的少数研究中被发现。然而，关于牙周病原体和中风之间的联系的证据还很缺乏。因此，这项研究的目的是在病例对照研究中调查血清主要牙周病原体抗体水平升高是否预测中风。方法：研究人群包括1973年至1976年在芬兰参加流动诊所健康调查的6950名受试者(年龄从45岁到)。在13年的随访中，共有173名受试者中风。从这些数据来看，受试者在基线时已经经历过中风或有冠心病的迹象，而109名受试者显然是健康的。每个病例的两名对照在年龄、性别、市政当局和疾病状况方面匹配。用多血清型酶联免疫吸附试验检测血清中对牙周病原体伴生放线杆菌和牙龈卟啉单胞菌的抗体水平。结果：随访期间无中风或冠心病的病例中伴生放线杆菌的IgA抗体阳性率高于对照组，分别为41.3%和29.3%。与血清阴性者相比，血清阳性者患中风的多变量优势比为1.6(95%CI，1.0~2.6)。基线时有中风或冠心病病史的患者，牙龈假单胞菌IgA血清阳性率高于对照组，分别为79.7%和70.2%。与血清阴性者相比，血清阳性者发生继发性中风的优势比为2.6(1.0比7.0)。结论：本前瞻性研究提供了血清学证据，表明牙周主要病原体引起的感染与未来中风有关。
Background and Purpose-The association between cerebrovascular events and periodontitis has been found in few studies based on clinical periodontal examinations. However, evidence on the association between periodontal pathogens and stroke is lacking. Therefore, the aim of the study was to investigate whether elevated levels of serum antibodies to major periodontal pathogens predict stroke in a case-control study.Methods-The study population comprised 6950 subjects (aged 45 to 64 years) who participated in the Mobile Clinic Health Survey in 1973 to 1976 in Finland. During a follow-up of 13 years, a total of 173 subjects had a stroke. From these, 64 subjects had already experienced a stroke or had signs of coronary heart disease (CHD) at baseline, whereas 109 subjects were apparently healthy. Two controls per case were matched for age, gender, municipality, and disease status. Serum IgG and IgA class antibody levels to the periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, were determined by multiserotype enzyme-linked immunosorbent assay.Results-The cases identified during the follow-up that were free of stroke or CHD at baseline were more often IgA-seropositive for A. actinomycetemcomitans than were their controls, 41.3% versus 29.3%. Compared with the seronegative, the seropositive subjects had a multivariate odds ratio of 1.6 (95% CI, 1.0 to 2.6) for stroke. The patients with a history of stroke or CHD at baseline were more often IgA-seropositive for P. gingivalis than were their controls, 79.7% versus 70.2%. When compared with the seronegative, the seropositive subjects had an odds ratio of 2.6 (1.0 to 7.0) for secondary stroke.Conclusions-The present prospective study provides serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.