Periodontitis, Biomarkers and Cardiovascular Disease

我们的总体目标是评估慢性牙周病和牙周炎发病率之间的关系， 心血管疾病，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）缺血性中风的风险增加。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： 对超过50，000名男性进行的随访研究，以及对超过100，000名女性进行的护士健康研究。我们 在相同人群中进行的前瞻性研究和其他几项研究已经获得资助，以评估 牙周病、炎症标志物和冠心病之间的关系。因此，我们限制 本研究旨在评估牙周骨丢失与缺血性卒中和PAD之间的关系。我们 已经证明牙周病和促炎细胞因子， 炎症和内皮功能障碍。我们将前瞻性地评估 牙周病的标准测量与PAD和缺血性卒中的发病率之间的关系，并评估 炎症和内皮功能障碍的标志物是否可以介导 牙周病和缺血性中风和PAD。这将是第一个评估这种关系的研究 牙周病和PAD之间的关系，并在第一个研究，前瞻性地评估 牙周病和心血管疾病之间的炎症介质的途径。我们将 包括所有事件病例和每个病例两个匹配对照，来自已提供血液的亚组 样本，并在要求这些参与者的 consets。将对血液样本参与者进行生化标志物分析， 我们拍牙科X光片。将根据病历验证缺血性卒中和PAD。我们预计 500例符合条件的缺血性卒中病例和500例PAD病例，每例病例2例匹配对照，总计 样本量为3000。由于牙周病非常常见，如果发现它会增加CVD的风险， 数百万人可能受到影响。这项研究的结果可能表明， CVD需要进一步探索。

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.