Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2011
[Detection of the parameters for early atherosclerosis in patients with metabolic syndrome and periodontitis].
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Li Peng, Zhang Da Kun, Zhang Ji Rui, Chen Li
Аннотация
OBJECTIVE: To observe whether chronic periodontitis (CP) and metabolic syndrome (MS) have synergistic effect on atherosclerosis.
METHODS: Fifty-nine patients with CP from dental clinic were enrolled in this study. According to the latest definition on MS, Twenty-six patients were diagnosed as MS by physicians. The periodontal status including plaque index, bleeding index, probing depth and attachment loss (AL) as well as missing teeth number were recorded by one periodentist. Intima-media thickness (IMT) and prevalence of atherosclerosis plaque of bilateral carotid common arteries and endothelial function (flow-mediated dilatation, FMD) were measured by high-frequency color Doppler. Carotid IMT and FMD were chosen to reflect the early vascular change in atherosclerosis.
RESULTS: AL in MS group was significantly higher than that in non-MS group [(2.91±1.84) vs. (1.97±1.74) mm, P=0.03],IMT and prevalence of atherosclerotic plaque in carotid common arteries was higher in MS group than that in non-MS group, statistically significant on left side [left: IMT (1.00±0.45) vs. (0.80±0.26) mm, P=0.04, right: IMT (0.87±0.44) vs. (0.78±0.31) mm , P=0.23;left prevalence of atherosclerotic plaque 34.62% vs. 9.09%, P=0.02,right prevalence of atherosclerotic plaque 19.23% vs. 9.09%, P=0.26]. FMD was significantly lower in the MS group than in the control group [(7.67±5.06) vs. (11.82±7.00), P=0.02]. As general condition and CP aggravating (No/mild periodontitis plus non-MS group, Moderate/severe periodontitis plus non-MS group, No/mild periodontitis plus MS group, Moderate/severe periodontitis plus MS group), carotid IMT increasing but not significantly [left: (0.76±0.27) mm, (0.85±0.24) mm, (0.84±0.33) mm, (1.08±0.49) mm correspondingly, P=0.06; right: (0.67±0.18) mm, (0.89± 0.37) mm, (0.78±0.30) mm, (0.92±0.49) mm correspondingly, P=0.08] and FMD decreasing, almost reach the statistical significance [(13.12±6.57)%, (10.43 ±7.43)%, (9.22±5.43)%, (6.98±4.89)% correspondingly, P=0.05]. Multiple linear regression showed that after adjusting factors of gender and smoking, the patient age was significant impact factor on carotid IMT [odds ratio (OR)=0.016, 95% confidence interval (CI): 0.01 to 0.02,P<0.01), after adjusting age, gender, smoking, MS (OR=-3.36, 95%CI-6.61 to-0.10,P=0.04) and severity of CP (OR=-2.67, 95%CI-4.70 to-0.62, P=0.01) were all significant impact factors on FMD.
CONCLUSION: CP and MS may have synergistic effect on the progression of atherosclerosis.
METHODS: Fifty-nine patients with CP from dental clinic were enrolled in this study. According to the latest definition on MS, Twenty-six patients were diagnosed as MS by physicians. The periodontal status including plaque index, bleeding index, probing depth and attachment loss (AL) as well as missing teeth number were recorded by one periodentist. Intima-media thickness (IMT) and prevalence of atherosclerosis plaque of bilateral carotid common arteries and endothelial function (flow-mediated dilatation, FMD) were measured by high-frequency color Doppler. Carotid IMT and FMD were chosen to reflect the early vascular change in atherosclerosis.
RESULTS: AL in MS group was significantly higher than that in non-MS group [(2.91±1.84) vs. (1.97±1.74) mm, P=0.03],IMT and prevalence of atherosclerotic plaque in carotid common arteries was higher in MS group than that in non-MS group, statistically significant on left side [left: IMT (1.00±0.45) vs. (0.80±0.26) mm, P=0.04, right: IMT (0.87±0.44) vs. (0.78±0.31) mm , P=0.23;left prevalence of atherosclerotic plaque 34.62% vs. 9.09%, P=0.02,right prevalence of atherosclerotic plaque 19.23% vs. 9.09%, P=0.26]. FMD was significantly lower in the MS group than in the control group [(7.67±5.06) vs. (11.82±7.00), P=0.02]. As general condition and CP aggravating (No/mild periodontitis plus non-MS group, Moderate/severe periodontitis plus non-MS group, No/mild periodontitis plus MS group, Moderate/severe periodontitis plus MS group), carotid IMT increasing but not significantly [left: (0.76±0.27) mm, (0.85±0.24) mm, (0.84±0.33) mm, (1.08±0.49) mm correspondingly, P=0.06; right: (0.67±0.18) mm, (0.89± 0.37) mm, (0.78±0.30) mm, (0.92±0.49) mm correspondingly, P=0.08] and FMD decreasing, almost reach the statistical significance [(13.12±6.57)%, (10.43 ±7.43)%, (9.22±5.43)%, (6.98±4.89)% correspondingly, P=0.05]. Multiple linear regression showed that after adjusting factors of gender and smoking, the patient age was significant impact factor on carotid IMT [odds ratio (OR)=0.016, 95% confidence interval (CI): 0.01 to 0.02,P<0.01), after adjusting age, gender, smoking, MS (OR=-3.36, 95%CI-6.61 to-0.10,P=0.04) and severity of CP (OR=-2.67, 95%CI-4.70 to-0.62, P=0.01) were all significant impact factors on FMD.
CONCLUSION: CP and MS may have synergistic effect on the progression of atherosclerosis.