After reading the lay article about how gum disease was linked to stroke and seeing the study they used I figured that I should reaad said study. This study was a pretty big one, at the beginning they had around 2,280 men that were interested in taking part in the study. When choosing people to be part of the study they looked at things like: levels of education, income, marital status, BMI, smoking, and quite a few more variables. Eventually the group was decreased to 1,137 males. There were two ways that they examined the teeth and how they compared to cerebrovascular disease these were: periodontal bone loss and cumulative probing depth. They study showed a positive association between periodontal bone loass and the incident of cerebrovascular disease. This association however was independent of cardivascular risk factors. They also found that there was a higher association with men that were younger than 65 years old. There was found to be no association with cumulative probing depth and incident of cerebrovascular disease. They believe that the casual (direct or indirect effect of infection and inflammatory response) and the non casual (chronic periodontitis) could be the cause of this association.
In terms of inflammation and how it relates to the study we could think of it as Dr. Cohen said in class. That the periodontal bone loss (periodontitis) could be looked at as being a response to chronic inflammation. While the probing depth is a result of acute inflammation.
I think that this study could be used as a starting point in a sense to fuel future studies that maybe focus on just the periodontal bone loss (periodontitis) and what factors of this could lead to cerebrovascular disease, in both men and women.
References:
Dietrich, Thomas, Elizabeth A. Krall, etal. "Periodontitis and Incidence of Cerebrovascular Disease in Men." Annals of Neurology 66.4 (2009): 505-12.
It is interesting to me that the researchers specifically indicate that the cerebrovascular disease observed in the study appears unrelated to cardiovascular disease, which is often more closely linked with cerebrovascular events like stroke than any other condition I can recall. However, I think their language is misleading, as they indicate, "We found a significant positive association between periodontal bone loss and the incidence of cerebrovascular disease (stroke and TIA), independent of important cardiovascular risk factors," on page 507, but the data on the next page shows that hypertension was observed in 18% of patients with cerebrovascular events compared to 11% of other individuals. The authors' statement remains accurate because it does not say, "independent of ALL cardiovascular risk factors," but a cursory glance at the statement would lead one to believe they completely eliminated the interplay of cardiovascular conditions in their study. Granted, it is nigh-on impossible to erase cardiovascular influence when evaluated a condition like stroke, but I believe a simple mention of the hypertension statistic was in order.
ReplyDelete*"cardiovascular risk factors", not "cardiovascular disease," please excuse my mistake
ReplyDeleteI agree there were some points that they could have gone more into detail with in the paper, hypertension being one of them. I felt that with this paper they there were a few areas that could have been explored more, but I guess that is what future research is for.
ReplyDeleteAnd to wheelchairs thank you for your comment and I am glad you liked it.