Periodontitis, Biomarkers and Cardiovascular Disease

描述（由申请人提供）：我们的总体目标是评估慢性牙周病和心血管疾病发病率之间的关联，并前瞻性地评估炎症生物标志物在这种关联中的作用。我们在男性中进行的流行病学研究结果显示，牙周病与（a）外周动脉疾病（PAD）和（B）缺血性卒中风险增加之间存在相关性。这项拟议的研究将在两项正在进行的前瞻性研究的男性和女性参与者中进行：卫生专业人员随访研究（有超过50，000名男性参与）和护士健康研究（有超过100，000名女性参与）。我们在相同人群中的前瞻性研究和其他几项研究已经被支持来评估牙周病，炎症标志物和冠心病之间的关联。因此，我们将此应用限于评估牙周骨丢失与缺血性卒中和PAD之间的关联。我们已经证明了牙周病和促炎细胞因子，炎症标志物和内皮功能障碍在这些队列之间的关联。我们将前瞻性评估牙周病标准测量与PAD和缺血性卒中发病率之间的关系，并评估炎症和内皮功能障碍标志物是否可能介导牙周病和缺血性卒中与PAD之间的关联。这将是第一项评估女性牙周病和PAD之间关系的研究，也是第一项前瞻性评估牙周病和心血管疾病之间通路中炎症介质的研究。我们将包括所有事件病例和每个病例的两个匹配对照，来自已经提供血液样本的亚组，并在征得这些参与者的同意后从他们的牙医那里获得他们先前存在的X光片。将对获得牙科X光片的受试者的血液样本进行生化标志物分析。将根据病历验证缺血性卒中和PAD。我们预计有500例符合条件的缺血性卒中病例和500例PAD病例，每例病例有2例匹配的对照，总样本量为3000例。由于牙周病非常常见，如果发现它会增加心血管疾病的风险，数百万人可能会受到影响。这项研究的结果可能表明预防CVD的可能性，需要进一步探索。

DESCRIPTION (provided by applicant): Our overall objective is to evaluate the association between chronic periodontal disease and incidence of cardiovascular disease, and to prospectively assess the role of inflammatory biomarkers in this association. Results from our epidemiologic studies among men show associations between periodontal disease and increased risk of (a) peripheral arterial disease (PAD) and (b) ischemic stroke. The proposed study will be conducted among male and female participants of two ongoing prospective studies: the Health Professionals' Follow-up Study, with over 50,000 men, and the Nurses' Health Study with over 100,000 women. Our prospective study in the same populations and several other studies are already supported to evaluate the association between periodontal disease, inflammatory markers and coronary heart disease. Hence we limit this application to evaluating the association between periodontal bone loss and ischemic stroke and PAD. We have demonstrated associations between periodontal disease and pro-inflammatory cytokines, markers of inflammation, and endothelial dysfunction in these cohorts. We will evaluate prospectively the relationship between standard measures of periodontal disease and incidence of PAD and ischemic stroke, and evaluate whether markers of inflammation and endothelial dysfunction may mediate the association between periodontal disease and ischemic stroke and PAD. This will be the first study to evaluate the relationship between periodontal disease and PAD among women, and among the first studies to prospectively evaluate inflammatory mediators in the pathway between periodontal disease and cardiovascular disease. We will include all incident cases and two matched controls per case, from the subgroup who already provided blood samples, and obtain their pre-existing radiographs from their dentists after requesting these participant's consent. The biochemical marker analyses will be conducted from the blood samples participants for whom we obtain dental radiographs. Ischemic stroke and PAD will be verified from medical records. We anticipate 500 eligible cases of ischemic stroke and 500 PAD cases and 2 matched controls per case, with a total sample size of 3,000. Since periodontal disease is very common, if it is found to increase the risk of CVD, millions of people may be impacted. The results from this study may suggest possibilities for prevention of CVD that would need to be further explored.