| Object:Substantial clinical and epidemical surveys showed that moderate or advanced periodontitis is in relation to cardiovascular diseases, especially the coronary heart diseases(CHD), but the true mechanism is still unknown.To explore the relationship between periodontal disease and coronary heart disease, some CHD patients with periodontitis or without periodontitis were chosen to make epidemic survey. Meanwhile, some of them have been taken saliva and gingival crevicular fluid to detect the level of platelet-activating factor(PAF) and blood sample have also been collected to observe the concentration of interleukin-23(IL-23) and interleukin-17 (IL-17) by enzyme linked immunosorbent assay(ELISA) compared with patients only with periodontitis and healthy controls.Methods:1. Subjects:120 subjects were divided into 4 groups according to the diagnostic angiography and periodontal examination as Group C+P, Group C, Group P and Group H. Group C+P was made up of 24 CHD patients with moderate to advanced periodontitis.36 CHD patients without periodontitis were as Group C. Group P was made up of 32 patients suffering moderate to advanced periodontitis. Group H was 28 healthy volunteers.2. Basic informations and Periodontal examination:The general informations and periodontal status(including probing depth,clinical attachment loss,simplified calculus index,bleeding on probing) of all the subjects were recorded.3. Specimens collection:unstimulated mixed saliva, GCF samples and serum samples were collected in sterile test tube, sealed and stored in -70℃low temperature refrigerator.4. Laboratory testing:Melted the speciments at room temperature and detected the levels of PAF,IL-23/IL-17 in serum and the level of Lp-PLA2 in unstimulated mixed saliva and GCF samples using ELISA method.5. Statistical analysis:SPSS13.0 statistical package was used to analyzed the data.The results were measured by mean±standard deviation,One-way ANOVA and least significant difference were used to compare the means of any two groups;Multivariate logistic regression analysis was used to assess the effect of different periodontal status on the onset of CHD;Correlation between two factors were analyzed using Spearman correlation analysis.All statistical tests referred to two-sided test,.P<0.05 was considered statistically significant.Results:1. Basic clinical data showed that the blood pressure,BMI of group C and group C+P were significantly higher than group P and group H,the difference was statistically significant(P<0.05);Clinical periodontal index showed that positive rate of BOP,PD and AL of group P and group C+P were higher than group C (P<0.05);the positive rate of BOP of the above three groups were higher than group H (P<0.05).2. One way analysis of variance showed that the PAF levels in saliva and GCF of group C,P,and C+P were significantly higher than that of group H. The PAF levels in saliva and GCF of group P and group C+P were higher than group C (P<0.05).Correlation analysis showed that the PAF levels in GCF of group C,group P and group C+P were positively correlated with PD and AL (P<0.05).3. The levels of IL-23/IL-17,Lp-PLA2 in serum from the patients of group C, P, and C+P were higher than group H,the differences were statistically significant (P<0.05).Correlation analysis showed that the serum IL-23/IL-17,Lp-PLA2 levels of group P and group C+P were positively correlated with PD and AL of respective group(P<0.05).Conclusion:1. The status of bleeding on probing and attachment loss in CHD patients is worse than the patients in control group.Periodontitis,as one of the independent risk factors of CHD may increase the hazard rate of suffering CHD.2. Inflammation of periodontal tissues can increase the secretion of PAF in saliva and GCF as well as IL-23/IL-17 and Lp-PLA2 in serum,which may be risk factors of coronary heart disease.It indicated that periodontitis may trigger and aggravate coronary heart disease by means of producing inflammatory mediators and the following cascade reactions, suggesting that periodontitis may be another risk factor for coronary heart disease. |
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