Endotoxemia, immune response to periodontal pathogens, and systemic inflammation associate with incident cardiovascular disease events
Endotoxemia, immune response to periodontal pathogens, and systemic inflammation associate with incident cardiovascular disease events
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DOI：
10.1161/atvbaha.106.138743
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发表时间：
2007-06-01
影响因子：
8.7
通讯作者：
Salomaa, Veikko
中科院分区：
文献类型：
--
作者：
Pussinen, Pirkko J.;Tuomisto, Karolina;Salomaa, Veikko
牙周炎中，革兰氏阴性菌的过度生长可引起内毒素血症和全身炎症，从而导致心血管疾病（CVD）。我们在一项前瞻性研究中调查了血清内毒素，牙周病原体抗体和炎症标志物与事件的风险CVD.Methods和Results-The FINRISK 1992年队列的6051人随访了10年。我们采用前瞻性病例队列设计研究了185例CVD事件和320例对照队列。对牙周病原体的高抗体应答独立预测CVD事件的发生，风险比（HR，四分位数4与四分位数1至3，95%CI）为1.87（1.13至3.08）。与低应答者相比，高抗体应答和高CRP或白细胞介素（IL）-6受试者的多变量校正HR分别为3.01（1.27至7.09）和3.11（1.42至6.83）。在调整年龄和性别后，高内毒素浓度的相应HR分别为1.82（1.22 - 2.73，单独）、3.92（1.99 - 7.74，与CRP）、3.54（1.78 - 7.03，与IL-6）和2.26（1.13 - 4.52，与肿瘤坏死因子（TNF）-α）。在调整血脂后，这些关联被消除。然而，高内毒素/高密度脂蛋白的比例，有一个多变量调整的风险比为1.92（1.19至3.08）的CVD events. Conclusions，我们的研究结果表明，暴露于牙周病原体或内毒素诱导全身炎症，从而增加CVD的风险。
Objective-In periodontitis, overgrowth of Gram-negative bacteria may cause endotoxemia and systemic inflammation leading to cardiovascular diseases (CVD). We investigated in a prospective study the associations of serum endotoxin, antibodies to periodontal pathogens, and inflammation markers with the risk of incident CVD.Methods and Results-The FINRISK 1992 cohort of 6051 individuals was followed up for 10 years. We examined 185 incident CVD events and a control cohort of 320 individuals using a prospective case-cohort design. High antibody response to periodontal pathogens independently predicted incident CVD events with hazard ratios (HR, quartile 4 versus quartiles 1 to 3, 95% CI) of 1.87 (1.13 to 3.08). The subjects with a high antibody response and high CRP or interleukin (IL)-6 had multivariate-adjusted HRs of 3.01 (1.27 to 7.09) and 3.11 (1.42 to 6.83) compared with low-responders, respectively. The corresponding HRs for high endotoxin concentration were 1.82 (1.22 to 2.73, alone), 3.92 (1.99 to 7.74, with CRP), 3.54 (1.78 to 7.03, with IL-6), and 2.26 (1.13 to 4.52, with tumor necrosis factor (TNF)-alpha) after adjusting for age and gender. These associations were abolished after adjusting for serum lipids. High endotoxin/HDL ratio, however, had a multivariate-adjusted HR of 1.92 (1.19 to 3.08) for CVD events.Conclusions-Our results suggest that the exposure to periodontal pathogens or endotoxin induces systemic inflammation leading to increased risk for CVD.