Radiographic Measures of Chronic Periodontitis and Carotid Artery Plaque
Identifieur interne : 001595 ( Ncbi/Merge ); précédent : 001594; suivant : 001596Radiographic 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 ; Ralph L. Sacco [États-Unis] ; Panos N. Papapanou [États-Unis] ; Moïse DesvarieuxSource :
- Stroke; a journal of cerebral circulation [ 0039-2499 ] ; 2005.
Abstract
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.
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.
Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm;
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.
Url:
DOI: 10.1161/01.STR.0000155734.34652.6c
PubMed: 15692118
PubMed Central: 2692923
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<series><title level="j">Stroke; a journal of cerebral circulation</title>
<idno type="ISSN">0039-2499</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background and Purpose</title>
<p id="P1">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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; <italic>P</italic>
=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; <italic>P</italic>
=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).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">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.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0235266</journal-id>
<journal-id journal-id-type="pubmed-jr-id">7613</journal-id>
<journal-id journal-id-type="nlm-ta">Stroke</journal-id>
<journal-title>Stroke; a journal of cerebral circulation</journal-title>
<issn pub-type="ppub">0039-2499</issn>
<issn pub-type="epub">1524-4628</issn>
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<article-id pub-id-type="pmc">2692923</article-id>
<article-id pub-id-type="doi">10.1161/01.STR.0000155734.34652.6c</article-id>
<article-id pub-id-type="manuscript">NIHMS99630</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Radiographic Measures of Chronic Periodontitis and Carotid Artery Plaque</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Engebretson</surname>
<given-names>Steven P.</given-names>
</name>
<degrees>DMD, MS</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lamster</surname>
<given-names>Ira B.</given-names>
</name>
<degrees>DDS, MMSc</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Elkind</surname>
<given-names>Mitchell S.V.</given-names>
</name>
<degrees>MD, MS</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rundek</surname>
<given-names>Tatjana</given-names>
</name>
<degrees>MD, PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Serman</surname>
<given-names>Neill J.</given-names>
</name>
<degrees>DDS</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Demmer</surname>
<given-names>Ryan T.</given-names>
</name>
<degrees>MPH</degrees>
<xref rid="A4" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sacco</surname>
<given-names>Ralph L.</given-names>
</name>
<degrees>MD, MS</degrees>
<xref rid="A2" ref-type="aff">2</xref>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Papapanou</surname>
<given-names>Panos N.</given-names>
</name>
<degrees>DDS, PhD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Desvarieux</surname>
<given-names>Moïse</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref rid="A4" ref-type="aff">4</xref>
<xref rid="A5" ref-type="aff">5</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Division of Periodontics, Section of Oral and Diagnostic Sciences, School of Dental and Oral Surgery, New York, NY</aff>
<aff id="A2"><label>2</label>
Departments of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, Sergievsky Center, New York, NY</aff>
<aff id="A3"><label>3</label>
Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY</aff>
<aff id="A4"><label>4</label>
Division of Epidemiology, School of Public Health and Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis</aff>
<aff id="A5"><label>5</label>
Department of Medicine, Medical School, University of Minnesota, Minneapolis</aff>
<author-notes><corresp id="FN1">Correspondence to Dr Steven P. Engebretson, School of Dental and Oral Surgery, Columbia University Medical Center, 630 W 168th St, PH7 E 125A New York, NY 10032. E-mail <email>spe3@columbia.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>16</day>
<month>3</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="epub"><day>3</day>
<month>2</month>
<year>2005</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2005</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>8</day>
<month>6</month>
<year>2009</year>
</pub-date>
<volume>36</volume>
<issue>3</issue>
<fpage>561</fpage>
<lpage>566</lpage>
<abstract><sec id="S1"><title>Background and Purpose</title>
<p id="P1">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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; <italic>P</italic>
=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; <italic>P</italic>
=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).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">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.</p>
</sec>
</abstract>
<kwd-group><kwd>alveolar bone loss</kwd>
<kwd>carotid stenosis</kwd>
<kwd>periodonitis</kwd>
<kwd>radiography</kwd>
<kwd>panoramic</kwd>
<kwd>ultrasonography</kwd>
</kwd-group>
<contract-num rid="NS1">R01 NS029993-14</contract-num>
<contract-sponsor id="NS1">National Institute of Neurological Disorders and Stroke : NINDS</contract-sponsor>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>État de New York</li>
</region>
</list>
<tree><noCountry><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="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>
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<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. Sacco</name>
</country>
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</affiliations>
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