Periodontitis, Biomarkers and Cardiovascular Disease

我们的总体目标是评估慢性牙周病与牙周病发病率之间的关系。 心血管疾病，并前瞻性地评估炎性生物标记物在这种关联中的作用。 我们在男性中的流行病学研究结果表明，牙周病和 增加(A)外周动脉疾病(PAD)和(B)缺血性中风的风险。拟议的研究将是 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：卫生专业人员的 对50,000多名男性进行了跟踪研究，对100,000多名女性进行了护士健康研究。我们的 相同人群中的前瞻性研究和其他几项研究已经得到资助，以评估 牙周病、炎症标志物与冠心病的关系。因此我们限制 本研究建议评估牙周骨丢失与缺血性卒中和PAD的关系。我们 已证明牙周病与促炎细胞因子、牙周炎标志物 这些队列中的炎症和内皮功能障碍。我们将对这一关系进行前瞻性评估 牙周病的标准测量与PAD和缺血性中风的发生率之间的关系，并评估 炎症标志物和血管内皮细胞功能障碍是否可能在 牙周病和缺血性中风和牙垫。这将是第一次评估这一关系的研究 女性牙周病和PAD之间的关系，并在第一批前瞻性评估的研究中 炎症介质在牙周病和心血管疾病之间的途径。我们会 包括所有事件病例和来自已经献血的亚组的每个病例两个匹配的对照 样本，并在要求这些参与者的牙医提供他们先前存在的X光片后 康塞斯。生化标记物分析将从受试者的血液样本中进行 我们得到了牙科X光片。缺血性中风和PAD将从医疗记录中得到核实。我们期待着 每个病例500例符合条件的缺血性卒中病例和500例PAD病例，以及2例匹配的对照，总计 样本量为3,000份。由于牙周病非常常见，如果发现它会增加患心血管疾病的风险， 数百万人可能会受到影响。这项研究的结果可能为预防该病提供了可能性 这是一个需要进一步探讨的问题。

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: Health Professionals' Follow-up Study with over 50,000 men, and Nurses' Health Study with over 100,000 women. Our prospective study in the same populations and several other studies are already funded to evaluate the association between periodontal disease, inflammatory markers and coronary heart disease. Hence we limit this proposal 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 consets. 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.