Periodontal disease and C-reactive protein-associated cardiovascular risk
Periodontal disease and C-reactive protein-associated cardiovascular risk
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DOI：
10.1111/j.1600-0765.2004.00731.x
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发表时间：
2004-08-01
影响因子：
3.5
通讯作者：
Tonetti, MS
中科院分区：
文献类型：
--
作者：
D'Aiuto, F;Ready, D;Tonetti, MS
背景：牙周炎与中度全身炎症反应有关。成功的牙周治疗可以降低血清炎症参数。本报告的目的是根据最近美国心脏协会 (AHA) 共识会议中定义的 C 反应蛋白 (CRP) 相关心血管疾病 (CVD) 风险的变化来探讨牙周治疗的结果。方法：94 名患有严重广泛性牙周炎的全身健康受试者接受了标准非手术牙周治疗。治疗后 2 个月和 6 个月监测牙周参数和血清炎症反应 [白细胞介素 6 (IL-6) 和 CRP]。 结果：在基线时，牙周炎较严重和广泛的受试者发生 CRP 相关 CVD 风险较高的机会较高（OR 5.6，95% CI 1.2-27.4）。年龄和体重指数在分析中也很重要。治疗后，观察到与中度和高度 CRP 相关风险相关的受试者数量显着减少 (p < 0.001 chi(2))，94 名受试者中有 40 名表现出其风险类别下降。对牙周治疗有更好口腔反应的患者在校正年龄、性别、种族和吸烟后，也更有可能降低炎症风险类别（OR 4.8，95% CI 1.4-15.8）。 结论：这项研究表明，牙周炎可能会增加个体的炎症负担，并可能导致基于血清 CRP 浓度的心血管风险水平增加。这些观察结果需要在最终试验中得到证实。鉴于牙周炎在人群中的患病率很高，这些数据提醒医生注意炎症负担增加的可能口腔来源。
Background: Periodontitis has been associated with a moderate systemic inflammatory response. Successful periodontal therapy could decrease serum inflammatory parameters. The aim of this report was to explore the outcomes of periodontal therapy in terms of changes in C-reactive protein (CRP)-associated cardiovascular disease (CVD) risk as defined in a recent American Heart Association (AHA) consensus conference.Methods: Ninety-four systemically healthy subjects suffering from severe generalized periodontitis received standard non-surgical periodontal therapy. Periodontal parameters and serum inflammatory responses [interleukin-6 (IL-6) and CRP] were monitored 2 and 6 months after therapy.Results: At baseline, subjects with more severe and widespread periodontitis had a higher chance of having high CRP-associated CVD risk (OR 5.6, 95% CI 1.2-27.4). Age and body mass index were also significant in the analysis. After therapy, a significant decrease in number of subjects associated with a medium and high CRP-associated risk was observed (p < 0.001 chi(2)), with 40 of 94 subjects displaying a decrease in their class of risk. Patients who had a better oral response to periodontal therapy were also more likely to have decreased their inflammatory risk category (OR 4.8, 95% CI 1.4-15.8) after correcting for age, gender, ethnicity and cigarette smoking.Conclusions: This study indicated that periodontitis may add to the inflammatory burden of the individual and may result in increased levels of cardiovascular risk based on serum CRP concentrations. These observations will need to be confirmed in a definitive trial. Given the high prevalence of periodontitis in the population, these data would caution physicians to be aware of the possible oral source of an increased inflammatory burden.