Radiographic measures of chronic periodontitis and carotid artery plaque
Identifieur interne : 002087 ( Main/Merge ); précédent : 002086; suivant : 002088Radiographic measures of chronic periodontitis and carotid artery plaque
Auteurs : Steven P. Engebretson [États-Unis] ; Ira B. Lamster [États-Unis] ; Mitchell S. V. Elkind [États-Unis] ; Tatjana Rundek ; Neill J. Serman ; Ryan T. Demmer [États-Unis] ; Ralph L. Sacco [États-Unis] ; Panos N. Papapanou [États-Unis] ; Moïse Desvarieux [États-Unis]Source :
- Stroke : (1970) [ 0039-2499 ] ; 2005.
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- Pascal (Inist)
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Abstract
Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.
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Engebretson</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Periodontics, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Lamster, Ira B" sort="Lamster, Ira B" uniqKey="Lamster I" first="Ira B." last="Lamster">Ira B. Lamster</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Periodontics, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Elkind, Mitchell S V" sort="Elkind, Mitchell S V" uniqKey="Elkind M" first="Mitchell S. V." last="Elkind">Mitchell S. V. Elkind</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Section of Oral and Diagnostic Sciences, School of Dental and Oral Surgery, Departments of Neurology, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Rundek, Tatjana" sort="Rundek, Tatjana" uniqKey="Rundek T" first="Tatjana" last="Rundek">Tatjana Rundek</name></author><author><name sortKey="Serman, Neill J" sort="Serman, Neill J" uniqKey="Serman N" first="Neill J." last="Serman">Neill J. Serman</name></author><author><name sortKey="Demmer, Ryan T" sort="Demmer, Ryan T" uniqKey="Demmer R" first="Ryan T." last="Demmer">Ryan T. Demmer</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Epidemiology, School of Public Health, University of Minnesota</s1><s2>Minneapolis</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis</wicri:noRegion></affiliation></author><author><name sortKey="Sacco, Ralph L" sort="Sacco, Ralph L" uniqKey="Sacco R" first="Ralph L." last="Sacco">Ralph L. Sacco</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Section of Oral and Diagnostic Sciences, School of Dental and Oral Surgery, Departments of Neurology, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>College of Physicians and Surgeons, Columbia University Medical Center, Sergievsky Center, and Epidemiology, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Papapanou, Panos N" sort="Papapanou, Panos N" uniqKey="Papapanou P" first="Panos N." last="Papapanou">Panos N. Papapanou</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Division of Periodontics, Joseph P. Mailman School of Public Health, Columbia University</s1><s2>New York, NY</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Desvarieux, Moise" sort="Desvarieux, Moise" uniqKey="Desvarieux M" first="Moïse" last="Desvarieux">Moïse Desvarieux</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Epidemiology, School of Public Health, University of Minnesota</s1><s2>Minneapolis</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Division of Infectious Diseases and International Medicine, Department of Medicine, Medical School, University of Minnesota</s1><s2>Minneapolis</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Carotid</term><term>Cerebrovascular disease</term><term>Chronic</term><term>Nervous system diseases</term><term>Periodontitis</term><term>Radiography</term><term>Stroke</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Radiographie</term><term>Chronique</term><term>Cérébrovasculaire pathologie</term><term>Carotide</term><term>Accident cérébrovasculaire</term><term>Parodontite</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>État de New York</li></region><settlement><li>New York</li></settlement><orgName><li>Université Columbia</li></orgName></list><tree><noCountry><name sortKey="Rundek, Tatjana" sort="Rundek, Tatjana" uniqKey="Rundek T" first="Tatjana" last="Rundek">Tatjana Rundek</name><name sortKey="Serman, Neill J" sort="Serman, Neill J" uniqKey="Serman N" first="Neill J." last="Serman">Neill J. Serman</name></noCountry><country name="États-Unis"><region name="État de New York"><name sortKey="Engebretson, Steven P" sort="Engebretson, Steven P" uniqKey="Engebretson S" first="Steven P." last="Engebretson">Steven P. Engebretson</name></region><name sortKey="Demmer, Ryan T" sort="Demmer, Ryan T" uniqKey="Demmer R" first="Ryan T." last="Demmer">Ryan T. Demmer</name><name sortKey="Desvarieux, Moise" sort="Desvarieux, Moise" uniqKey="Desvarieux M" first="Moïse" last="Desvarieux">Moïse Desvarieux</name><name sortKey="Desvarieux, Moise" sort="Desvarieux, Moise" uniqKey="Desvarieux M" first="Moïse" last="Desvarieux">Moïse Desvarieux</name><name sortKey="Elkind, Mitchell S V" sort="Elkind, Mitchell S V" uniqKey="Elkind M" first="Mitchell S. V." last="Elkind">Mitchell S. V. Elkind</name><name sortKey="Lamster, Ira B" sort="Lamster, Ira B" uniqKey="Lamster I" first="Ira B." last="Lamster">Ira B. Lamster</name><name sortKey="Papapanou, Panos N" sort="Papapanou, Panos N" uniqKey="Papapanou P" first="Panos N." last="Papapanou">Panos N. Papapanou</name><name sortKey="Sacco, Ralph L" sort="Sacco, Ralph L" uniqKey="Sacco R" first="Ralph L." last="Sacco">Ralph L. Sacco</name><name sortKey="Sacco, Ralph L" sort="Sacco, Ralph L" uniqKey="Sacco R" first="Ralph L." last="Sacco">Ralph L. 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