牙周炎、牙科手术与青年隐源性中风

IF 8.3 2区 材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY
J. Leskelä, J. Putaala, N. Martinez-Majander, L. Tulkki, M. Manzoor, S. Zaric, P. Ylikotila, R. Lautamäki, A. Saraste, S. Suihko, E. Könönen, J. Sinisalo, P.J. Pussinen, S. Paju
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引用次数: 0

摘要

牙周炎与缺血性脑卒中风险的增加有关,在脑卒中病因不明的年轻人中,这种风险可能尤其高。因此,我们在一项病例对照研究中调查了牙周炎或最近的侵入性牙科治疗是否与年轻时发生的隐源性缺血性中风(CIS)有关。我们从一项多中心病例对照 SECRETO 研究中招募了参与者,包括年龄在 18 至 49 岁、首次出现影像学阳性 CIS 的成人,以及无中风的年龄和性别匹配的对照组。我们进行了全面的临床和放射口腔检查。此外,我们还测量了血清脂多糖(LPS)和脂回声酸(LTA)水平。多变量条件回归模型对中风风险因素、定期看牙医和卵圆孔状态进行了调整。我们共纳入了 146 对病例对照(中位年龄为 41.9 岁;58.2% 为男性)。27.5%的CIS患者和20.1%的对照组患者被诊断患有牙周炎(P < 0.001)。在完全调整模型中,CIS 与高牙周炎症负担有关(几率比 [OR],95% 置信区间),OR 为 10.48(3.18-34.5),与严重牙周炎有关,OR 为 7.48(1.24-44.9)。脑卒中严重程度随牙周炎严重程度的增加而增加,III 至 IV 期 C 级的 OR 为 6.43(1.87-23.0)。脑卒中前 3 个月内进行的侵入性牙科治疗与 CIS 相关,OR 为 2.54(1.01-6.39)。在患有 PFO 的患者中,CIS 与侵入性牙科治疗之间的关系尤为密切,OR 值为 6.26(1.72-40.2)。LPS/LTA 在 CIS 患者和对照组之间没有差异,但随着牙周炎严重程度的增加而呈上升趋势。在控制了多种混杂因素后,牙周炎和最近的侵入性牙科手术与 CIS 相关。然而,菌血症在这一风险中的中介作用并未得到证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Periodontitis, Dental Procedures, and Young-Onset Cryptogenic Stroke
Periodontitis is associated with an increased risk of ischemic stroke, and the risk may be particularly high among young people with unexplained stroke etiology. Thus, we investigated in a case-control study whether periodontitis or recent invasive dental treatments are associated with young-onset cryptogenic ischemic stroke (CIS). We enrolled participants from a multicenter case-control SECRETO study including adults aged 18 to 49 y presenting with an imaging-positive first-ever CIS and stroke-free age- and sex-matched controls. Thorough clinical and radiographic oral examination was performed. Furthermore, we measured serum lipopolysaccharide (LPS) and lipotechoic acid (LTA) levels. Multivariate conditional regression models were adjusted for stroke risk factors, regular dentist visits, and patent foramen ovale (PFO) status. We enrolled 146 case-control pairs (median age 41.9 y; 58.2% males). Periodontitis was diagnosed in 27.5% of CIS patients and 20.1% of controls ( P < 0.001). In the fully adjusted models, CIS was associated with high periodontal inflammation burden (odds ratio [OR], 95% confidence interval) with an OR of 10.48 (3.18–34.5) and severe periodontitis with an OR of 7.48 (1.24–44.9). Stroke severity increased with the severity of periodontitis, having an OR of 6.43 (1.87–23.0) in stage III to IV, grade C. Invasive dental treatments performed within 3 mo prestroke were associated with CIS, with an OR of 2.54 (1.01–6.39). Association between CIS and invasive dental treatments was especially strong among those with PFO showing an OR of 6.26 (1.72–40.2). LPS/LTA did not differ between CIS patients and controls but displayed an increasing trend with periodontitis severity. Periodontitis and recent invasive dental procedures were associated with CIS after controlling for multiple confounders. However, the role of bacteremia as a mediator of this risk was not confirmed.
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来源期刊
ACS Applied Materials & Interfaces
ACS Applied Materials & Interfaces 工程技术-材料科学:综合
CiteScore
16.00
自引率
6.30%
发文量
4978
审稿时长
1.8 months
期刊介绍: ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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