Association between oral health and the risk of lacunar infarction in Japanese adults.
Association between oral health and the risk of lacunar infarction in Japanese adults.
复制标题
日本成年人口腔健康与腔隙性梗塞风险之间的关联。
DOI：
10.1159/000353707
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发表时间：
2013
期刊：
影响因子：
3.5
通讯作者：
Yoshinari N.
中科院分区：
文献类型：
--
作者：
Taguchi A;Miki M;Muto A;Kubokawa K;Migita K;Higashi Y;Yoshinari N.
背景：口腔健康不良与老年人患痴呆症的风险增加有关。将这两种现象联系起来的一个可能途径是腔隙性脑梗塞，这是痴呆症的一个潜在原因。口腔健康状况不佳与缺血性中风风险增加之间的联系已经通过口腔感染-炎症途径被认识到。目的：通过磁共振成像(MRI)检测口腔健康相关变量与腔隙性脑梗塞之间的关系。方法：共110例患者(男52例，女58例)，年龄27-76岁，均为牙周病门诊就诊者。受试者接受牙科X线片、牙周检查和脑MRI检查。一名经验丰富的心血管疾病专家和一名经验丰富的神经外科医生在脑部MRI上确定了腔隙梗塞的数量。牙周科医生进行临床牙周检查。口腔放射科医生根据X光片确定了与口腔健康相关的变量。关于受试者的生活方式和病史的信息是通过结构化问卷获得的，并得到了临床记录的证实。结果：110例受试者中，61例为腔隙性脑梗塞。19例有多发(≥7)病变。在最终回归模型中，年龄(p=0.0004)、每天体力活动时间增加(p=0.042)、高血压(p=0.006)、无高脂血症(p=0.045)、糖尿病(p=0.025)和低牙槽骨高度(p=0.026)与腔隙梗死数目增加显著相关。高脂血症和牙槽骨高度的意义在未调整的模型中消失。口袋深度的增加，表明当前牙周疾病的进展，往往与腔隙梗死的数量增加有关(p=0.058)。这一趋势在未经调整的模型中并未消失。结论：我们的结果表明腔隙梗死可能与当前日本成年人的牙周病有关。
Background:Poor oral health is associated with an increased risk of dementia in the elderly. One possible pathway linking these two phenomena is lacunar infarction, a potential cause of dementia. An association between poor oral health and an increased risk of ischaemic stroke has been recognised through the oral infection-inflammation pathway. However, little is known about whether poor oral health is associated with the progression of lacunar infarction.Objective:We examined the association between variables related to oral health and lacunar infarction, as detected by magnetic resonance imaging (MRI).Methods:A total of 110 subjects (52 men, 58 women), aged 27-76 years, who visited our periodontology clinic participated in this study. The subjects underwent dental radiography, periodontal examinations and brain MRI. One experienced specialist in cardiovascular disease and one experienced neurosurgeon determined the number of lacunar infarctions on brain MRI. Periodontologists performed clinical periodontal examinations. Variables related to oral health were determined from the radiographs by an oral radiologist. Information on the subjects' lifestyles and disease histories were obtained using a structured questionnaire and confirmed by clinical records. Adjacent categories logit regression analysis with backward elimination was used to determine variables associated with three groups based on the number of lacunar infarctions.Results:Of the 110 subjects, 61 had lacunar infarctions. Nineteen had multiple (≥7) lesions. Aging (p = 0.0004), increased time spent in physical activity per day (p = 0.042), the presence of hypertension (p = 0.006), the absence of hyperlipidaemia (p = 0.045), the presence of diabetes mellitus (p = 0.025) and low alveolar bone height (p = 0.026) were significantly associated with an increased number of lacunar infarctions in the final regression model. The significance of hyperlipidaemia and alveolar bone height disappeared in an unadjusted model. An increased pocket depth, which indicates current periodontal disease progression, tended to be associated with an increased number of lacunar infarctions (p = 0.058). This tendency did not disappear in an unadjusted model.Conclusion:Our results suggest that lacunar infarction may be associated with current periodontal disease in Japanese adults.