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Systemic exposure to Porphyromonas gingivalis predicts incident stroke

  • Pirkko J. Pussinen
    Correspondence
    Corresponding author. Tel.: +358 9 191 25211; fax: +358 9 191 25194.
    Affiliations
    Institute of Dentistry, University of Helsinki, P.O. Box 63, FI-00014 Helsinki, Finland

    Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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  • Georg Alfthan
    Affiliations
    Biomarker Laboratory, Department of Health and Functional Ability, KTL-National Public Health Institute, Helsinki, Finland
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  • Pekka Jousilahti
    Affiliations
    Department of Public Health, University of Helsinki, Helsinki, Finland

    Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Helsinki, Finland
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  • Susanna Paju
    Affiliations
    Institute of Dentistry, University of Helsinki, P.O. Box 63, FI-00014 Helsinki, Finland

    Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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  • Jaakko Tuomilehto
    Affiliations
    Department of Public Health, University of Helsinki, Helsinki, Finland

    Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Helsinki, Finland

    South Ostrobothnia Central Hospital, Seinäjoki, Finland
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      Abstract

      Periodontitis has been associated with an increased risk for atherosclerosis. Prospective data concerning its association with risk of stroke, especially those measuring systemic exposure to periodontal pathogens, are scarce. We analyzed if serum antibody levels to two major periodontopathogens predict stroke.
      The cases and the controls were nested in a random population-based sample of 8911 subjects aged 30–59 years at baseline, who participated in a cardiovascular disease (CVD) risk factor survey in Eastern Finland in 1977 and were followed for 15 years. CVD-free controls (n = 516) were matched for sex and 5-year age group with stroke cases (n = 470).
      In subjects free from CVD at baseline (n = 893), systemic exposure to Porphyromonas gingivalis increased the risk of stroke: compared to seronegative subjects, men IgA-seropositive and women IgG-seropositive for P. gingivalis had a multivariate odds ratio (OR) (95% CI) of 1.63 (1.06–2.50) and 2.30 (1.39–3.78) for stroke, respectively. Higher OR was observed in males, who had never smoked: compared to seronegative men, P. gingivalis IgA-seropositive men had a multivariate OR of 3.31 (1.31–8.40, p = 0.012) for stroke. No association between antibody levels to Actinobacillus actinomycetemcomitans and stroke was found.
      The results suggest that the systemic exposure to P. gingivalis may predispose to incident stroke.

      Keywords

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