CHRONIC DENTAL DISEASE AND CARDIOVASCULAR DISEASE

慢性牙科疾病和心血管疾病

• 批准号: 2864863
• 负责人: KAUMUDI J JOSHIPURA
• 金额: $ 19.52万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-30 至 2003-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2864863
• 关键词: acute phase protein; antioxidants; biomarker; blood chemistry; chronic disease /disorder; clinical research; coagulation factor VII; coronary disorder; dental caries; dietary fiber; disease /disorder proneness /risk; epidemiology; fibrinogen; health care personnel; health surveys; human subject; longitudinal human study; nutrition related tag; periodontitis; plasminogen activator; questionnaires; stroke; tooth loss; von Willebrand factor

Several recent reports have found significant associations between periodontal disease, tooth loss and increased coronary heart disease (CHD). Possible associations between dental caries and CHD and between dental disease and stroke have also been reported. Recent literature also supports the possible role of other chronic bacterial and viral infection, fibrinogen and other inflammatory mediators in increasing CHD risk. We propose to study the relation between periodontal disease, caries and tooth loss, and risk of incidence of coronary heart disease and stroke and to assess if these associations are independent of common risk factors including behavioral factors. Additionally, we propose to evaluate two possible explanations for these associations: (1) tooth loss leads to reduced masticatory efficiency, which could lead to reduced intake of dietary antioxidant and fiber, which in turn has been associated with increased risk for cardiovascular disease; and (2) chronic dental disease could lead to hyperfibrinogenemia which is strongly and probably causally associated with increased risk of CHD. We will also evaluate C-reactive protein, von Willebrand factor, tissue plasminogen activator, and Factor VII as additional mediators. Participants include 51,529 men enrolled in the Health Professionals Follow-Up Study since 1986 and 90,000 females enrolled in the Nurses Health Study since 1976 who reported their dental status in 1992. The follow-up in these cohorts is excellent and has been consistently over 90 percent. The outcome measures will include incident cases of CHD and stroke in 15 years of follow-up among men and 9 years of follow-up among women free of cardiovascular disease and cancer at baseline. Over 4500 incident cases of CHD and stroke are anticipated. Biomarker assays will be performed for a sub-population consisting of new CHD cases incident after the time of initial blood collection, and one matched control per case. Blood samples were provided by 32,000 nurses in 1989-90 and by 18,100 male health professionals in 1993-94, allowing for sufficient follow-up to include an estimated 600 incident cases among males and 600 cases among females for the biomarker analyses. The high prevalence of dental infection makes its potential association with inflammatory and dietary mediators, and ultimately increased risk of CHD and stroke very important with implications for millions of Americans.

最近的几份报告发现， 牙周病、牙齿脱落和冠心病增加 （CHD）。 龋齿与冠心病之间的可能联系以及 牙病和中风也有报道。 最近的文献 也支持其他慢性细菌和病毒的可能作用 感染、纤维蛋白原和其他炎症介质在增加CHD中的作用 风险 我们建议研究牙周病， 龋齿和牙齿脱落，以及冠心病发病风险 并评估这些关联是否独立于常见的 风险因素包括行为因素。 此外，我们建议 评估这些关联的两种可能的解释：（1）牙齿 损失会导致咀嚼效率降低，从而可能导致 减少膳食抗氧化剂和纤维的摄入，这反过来又被 与心血管疾病风险增加相关;和（2） 慢性牙病可能导致高纤维蛋白原血症， 与CHD风险增加有很强且可能的因果关系。 我们还将评估C反应蛋白，血管性血友病因子，组织 纤溶酶原激活剂和因子VII作为额外的介质。 参与者包括51，529名注册为卫生专业人员的男性 自1986年以来的跟踪研究，90 000名女性参加了护士培训 健康研究自1976年以来，他们在1992年报告了他们的牙齿状况。 的 这些队列的随访非常好， 百分之九十 结局指标将包括CHD的发病病例， 男性15年随访和男性9年随访的卒中发生率 基线时无心血管疾病和癌症的女性。 超过4500 冠心病和中风的发病病例是可以预见的。 生物标志物检测将 对由新发CHD病例事件组成的亚群进行 在初次采血后，每只大鼠取一只匹配的对照组， 案子 1989- 1990年，32，000名护士提供了血液样本， 1993- 1994年有18 100名男性保健专业人员， 后续行动包括估计600例男性和600例 用于生物标志物分析的女性病例。 的高患病率 牙齿感染可能与炎症和 饮食介质，并最终增加冠心病和中风的风险非常 这对数百万美国人来说意义重大。