Abstract：
BACKGROUND: Periodontal disease may be an important modifiable risk factor for stroke.
OBJECTIVE: To determine the contribution of markers of periodontal disease to stroke risk globally, within subpopulations, and by stroke subtypes.
METHODS: INTERSTROKE is the largest international case-control study of risk factors for first acute stroke. All participants were asked a standardised set of questions about the presence or absence of painful teeth, painful gums or lost teeth, as markers of periodontal disease, within the previous year. The total number of reported variables was calculated per participant. Multivariable conditional logistic regression examined the association of these variables with acute stroke.
RESULTS: In 26901 participants, across 32 countries, there was a significant multivariable association between lost teeth and stroke (OR 1.11, 95 % CI 1.01 - 1.22), but not painful teeth (OR 1.00, 95 % CI 0.91-1.10) or painful gums (OR 1.01, 95 % CI 0.89 - 1.14). When these symptoms were considered together there was a graded increased odds of stroke, with the largest magnitude of association seen if a patient reported all three of painful teeth, painful gums and lost teeth (OR 1.34, 95 % CI 1.00 - 1.79).
CONCLUSIONS: Our findings suggest that features of severe periodontal disease are a risk factor for acute stroke. Periodontal disease should be considered as a potentially modifiable risk factor for stroke.
OBJECTIVE: To determine the contribution of markers of periodontal disease to stroke risk globally, within subpopulations, and by stroke subtypes.
METHODS: INTERSTROKE is the largest international case-control study of risk factors for first acute stroke. All participants were asked a standardised set of questions about the presence or absence of painful teeth, painful gums or lost teeth, as markers of periodontal disease, within the previous year. The total number of reported variables was calculated per participant. Multivariable conditional logistic regression examined the association of these variables with acute stroke.
RESULTS: In 26901 participants, across 32 countries, there was a significant multivariable association between lost teeth and stroke (OR 1.11, 95 % CI 1.01 - 1.22), but not painful teeth (OR 1.00, 95 % CI 0.91-1.10) or painful gums (OR 1.01, 95 % CI 0.89 - 1.14). When these symptoms were considered together there was a graded increased odds of stroke, with the largest magnitude of association seen if a patient reported all three of painful teeth, painful gums and lost teeth (OR 1.34, 95 % CI 1.00 - 1.79).
CONCLUSIONS: Our findings suggest that features of severe periodontal disease are a risk factor for acute stroke. Periodontal disease should be considered as a potentially modifiable risk factor for stroke.
摘要：
背景牙周病可能是卒中的一个重要的可改变的危险因素。目的确定牙周病标志物对全球卒中风险的贡献，在亚群中，和中风亚型。方法INTERSTROKE是国际上最大的首次急性卒中危险因素病例对照研究。所有参与者都被问到一组关于牙齿疼痛的标准化问题，牙龈疼痛或牙齿脱落，作为牙周病的标志，前一年内。每个参与者计算报告变量的总数。多变量条件逻辑回归分析了这些变量与急性卒中的相关性。结果在26901名参与者中，在32个国家,牙齿脱落和中风之间存在显著的多变量关联(OR1.11,95%CI1.01-1.22),但没有牙齿疼痛（OR1.00，95％CI0.91-1.10）或牙龈疼痛（OR1.01，95％CI0.89-1.14）。当这些症状一起考虑时，中风的几率分级增加，如果患者报告所有三颗牙齿疼痛，牙龈疼痛和牙齿脱落(OR1.34，95%CI1.00-1.79)。结论我们的发现表明，严重牙周病的特征是急性中风的危险因素。牙周病应被视为中风的潜在可改变的危险因素。
