Relationship between periodontal disease and C-reactive protein among adults in the atherosclerosis risk in communities study
Relationship between periodontal disease and C-reactive protein among adults in the atherosclerosis risk in communities study
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DOI：
10.1001/archinte.163.10.1172
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发表时间：
2003-05-26
影响因子：
--
通讯作者：
Offenbacher, S
中科院分区：
文献类型：
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作者：
Slade, GD;Ghezzi, EM;Offenbacher, S
背景资料：中度升高的血清C反应蛋白（CRP）浓度是炎症的全身标志物，也是其他健康人群中心血管疾病的危险因素。未识别的感染，如牙周病，可能会引起急性期反应，升高CRP水平。我们评估了牙周病和CRP水平在成人之间的关联在社区study.Methods的动脉粥样硬化风险：1996年1月1日，1998年12月31日，5552 ARIC参与者（年龄52-74岁）从4个美国社区之间进行了口腔检查。牙周病被量化为牙周袋深度为4 mm或更大的牙周部位的百分比。血清CRP浓度采用酶联免疫吸附测定法（ELISA）以毫克/升为单位进行定量。结果：牙周袋广泛（牙周袋深度大于或等于4 mm的部位>30%）的患者的平均（SE）CRP水平为7.6（0.6）mg/L，大约比牙周袋不太广泛的患者（5.7 [0.1] mg/L）高三分之一。在控制年龄、性别、糖尿病、吸烟和非甾体抗炎药使用的多变量线性回归模型中，通过体重指数（BMI;计算方法为体重（kg）除以身高（m）的平方）修改广泛牙周袋与CRP浓度的相关性。对于BMI为20的人，模型预测牙周袋组之间的平均CRP浓度有2倍的差异（7.5 vs 3.6 mg/L），但随着BMI的增加，差异逐渐减小，当BMI等于35时，差异可以忽略不计。在其他方面健康的中年人中，广泛的牙周病和BMI与CRP水平升高相关，提示在评估某些患者的急性期反应来源时需要进行医学和牙科诊断。
Background: Moderately elevated serum C-reactive protein (CRP) concentration is a systemic marker of inflammation and a documented risk factor for cardiovascular disease in otherwise healthy persons. Unrecognized infections, such as periodontal disease, may induce an acute-phase response, elevating CRP levels. We evaluated the association between periodontal disease and CRP levels in adults in the Atherosclerosis Risk in Communities study.Methods: Oral examinations were conducted between January 1, 1996, and December 31, 1998, on 5552 ARIC participants (aged 52-74 years) from 4 US communities. Periodontal disease was quantified as the percentage of periodontal sites with pocket depth of 4 mm or more. Serum CRP concentration was quantified in milligrams per liter using an enzyme-linked immunosorbent assay.Results: Mean (SE) CRP level was 7.6 (0.6) mg/L among people with extensive periodontal pockets (>30% of sites with pocket depth greater than or equal to4 mm), approximately one-third greater than that for people with less extensive periodontal pockets (5.7 [0.1] mg/L). In a multivariable linear regression model that controlled for age, sex, diabetes mellitus, cigarette use, and nonsteroidal anti-inflammatory drug use, the association of extensive periodontal pockets with CRP concentration was modified by body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters). For people with a BMI of 20, the model predicted a 2-fold difference in mean CRP concentration between periodontal pocket groups (7.5 vs 3.6 mg/L), but the difference decreased with increasing BMI and was negligible when BMI equaled 35.Conclusions: Extensive periodontal disease and BMI are jointly associated with increased CRP levels in otherwise healthy, middle-aged adults, suggesting the need for medical and dental diagnoses when evaluating sources of acute-phase response in some patients.