Preliminary Study On Relationship Between Periodontal Condition And Lacunar Stroke

TitlePreliminary study on relationship between periodontal condition and lacunar strokeObjectivePeriodontal disease and lacunar infarction are common diseases with a higher incidence in the elderly people. Periodontal disease can increase the systemic inflammatory markers, promote formation of atherosclerosis related to inflammation. Atherosclerosis is one of major causes of the lacunar infarction. In this study, a survey on periodontal health status and lacunar infarction was conducted with part of retired cadres in Shenyang City, who took the annual physical examination. The data obtained in this survey were analyzed in order to investigate the epidemiology of periodontal condition and lacunar infarction, and the effects of periodontal condition on indicators of blood lipids and blood rheology in the patients.MethodsAfter excluding people with diabetes and chronic bronchitis, emphysema and other inflammatory diseases in patients, 777 retired cadres who participated in physical examination were investigated for their gingival index (GI), clinical attachment loss (CAL) and the number of missing teeth. At the same time, systemic conditions, including age, gender, smoking status, body mass index, family heredity history, and other diseases were recorded. The patients with lacunar infarction were diagnosed by cranial CT. By calculating the prevalence of lacunar infarction of this population, comparing patients' periodontal health status such as the gingival index, clinical attachment loss, missing teeth among the patients with and without lacunar infarction, the risk factors of the lacunar infarction were studied. At the same time, according to the gingival index, the patients with lacunar infarction were divided into three groups of non-gingivitis, mild to moderate gingivitis and severe gingivitis. Thereafter, the indicators of blood lipid and blood rheology were compared among these groups.ResultsThe prevalence of lacunar infarction among the 777 retired cadres in Shenyang City was 8.37%, which is higher than the national average. The prevalence of edentulous jaw in lacunar infarction group is not significantly higher than non-lacunar infarction group. After cases with full-mouth tooth loss were excluded, the 705 subjects were included in the scope of sample. The prevalence of gingival index of the lacunar infarction group were significantly higher than that of non-lacunar infarction group (P=0.0018). The prevalence rate of severe gingivitis (GI≥2.1) of lacunar infarction Group is 36.2%, which is significantly higher than that of the non-lacunar infarction Group (17.5%) (P <0.01). Percentage of Clinical attachment loss CAL≥5mm in lacunar infarction Group is more than non-lacunar infarction Group (P <0.05), no statistical difference of averaged CAL and 5mm> CAL≥3mm between the 2 groups. No significant difference of the missing teeth number between the two groups. Results of logistic regression analysis showed that risk factors of lacunar infarction disease included age, hypertension and severe gingivitis. The crowd with lacunar infarction was examined for their blood lipid and blood rheology, it was found that fibrinogen in patients with severe gingivitis was significantly higher than in patients with mild to moderate gingivitis. No statistically significant difference was found among other indicators of blood lipid and blood rheology.ConclusionsThe prevalence of lacunar infarction for part of retired cadres in Shenyang City is as follows: 8.37%, which is higher than the national standards. The gingival index and prevalence of severe gingivitis in patients with lacunar infarction were significant higher than patients without lacunar infarction. This indicates patients with lacunar infarction have a heavier level of gum infection. Percentage of Clinical attachment loss CAL≥5mm in lacunar infarction Group is more than non-lacunar infarction Group (P <0.05). This indicates a larger extension of severe periodontitis. The possible risk factors of lacunar infarction according to the order of influence are age, hypertension, severe gingivitis. The severe gingivitis is closely related to lacunar infarction. The fibrinogen in patients with severe gingivitis was significantly higher than in patients with mild to moderate gingivitis. This may promote the recurrence of lacunar infarction.In summary, the results of this study supports that there is epidemiological relationship between periodontal health status and lacunar infarction. It is also found that severe gingivitis is closely related to the occurrence of lacunar infarction.