台灣漢族華人IL-6 -572 C/G, IL-10 -592 T/G及染色體9P21.3單一核苷酸多型性、牙周炎與心臟血管狹窄、急性心肌梗塞關連性

The investigation in the correlation of IL-6 -572 C/G, IL-10 -792 T/G, chromosome 9P21.3 polymorphisms/ periodontitis with cardiac artery stenosis and acute myocardial infraction

游智凱(Chih-kai Yu)

指導教授 ： 吳逸民

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2014年)

摘要

研究目的：
發炎反應在牙周炎及心血管疾病中均扮演重要的角色，在兩種疾病中的致病機轉及關聯性長久以來一直受到討論及研究。在部分文獻也討論到基因及牙周炎及心血管疾病之間的相關聯性。本研究目的在探討台灣漢族華人IL-6 -572 C/G、IL-10 -592 T/G及染色體9P21.3單一核苷酸多型性、牙周炎與心臟血管狹窄及急性心肌梗塞關連性
材料與方法：
222位心臟內科病患，依據心導管及64切電腦斷層檢查結果以及心肌梗塞病史，分為無心血管狹窄組到3條心血管狹窄組共四組；另以有無心肌梗塞病史區分，分為有心肌梗塞病史組及無心肌梗塞病史組。並針對牙齒喪失數、牙周囊袋探測深度(PD)、臨床附連水平喪失(CAL)、探測出血比例(BOP)、牙菌斑(plaque)比例等牙周參數進行記錄。單一核苷酸多型性則依據樣本IL-6 -572(rs1800796)、IL-10 -592(rs1800872)、染色體9P21.3(rs10757278)進行基因多形性分析。依據並統合以上資料進行單一核苷酸多型性、牙周炎、心血管疾病之間相關連性分析。
結果：
牙周炎與動脈狹窄相關性部分，3條動脈狹窄組有較多的牙齒喪失數(3 vs.1， p=0.089 ； 3 vs.0， p=0.0078)、較多的平均臨床附連水平喪失(3 vs.2， p=0.0134 ； 3 vs.1， p=0.0029) ； 3 vs.0， p<0.0001)以及較高的臨床附連水平喪失≧5 mm百分比(3 vs.2， p=0.0022 ；3 vs.1， p=0.0002 ； 3 vs.0， p<0.0001)；牙周炎與心肌梗塞相關性，心肌梗塞病史組相較無病史者在統計學上有顯著較高的臨床附連水平喪失(p=0.0172)及臨床附連水平喪失≧5 mm百分比(p=0.0209)；牙周炎與單一核苷酸多型性部分，IL-10 -592 G基因型對於牙周炎有一保護性影響，IL-6 -572 C/G及染色體9P21.3則未達統計學上顯著相關性。心臟動脈狹窄有無與男性(OR=5.83， p<0.0001)、糖尿病史(OR=1.96， p=0.0423)、抽菸pack-year > 30 (OR=2.50， p=0.0440)有關，但與單一核苷酸多型性部分經多因子邏輯回歸分析後則均未達統計學上顯著相關性
結論：
本研究在有限的樣本數下發現，較多條動脈狹窄組比起較少動脈狹窄組，及心肌梗塞病史組比起無心肌梗塞病史組，皆有較嚴重牙周組織破壞。心肌梗塞病史與動脈狹窄和單一核苷酸多型性皆不具相關性;在牙周炎嚴重度和單一核苷酸多型性方面，IL-6 -572 G基因型對於牙周炎有一保護性的影響，IL-10 -592以及染色體9P21.3單一核苷酸多型性部分則無顯著影響。

關鍵字

牙周病 ； 心臟血管狹窄 ； 基因多型性

並列摘要

Object:
The purpose of this study is to investigate the relationship of IL-6 -572 C/G、IL-10-592 T/G and chromosome 9P21.3 gene polymorphism in periodontitis and cardiovascular disease.
Materials and methods:
According to the result of cardiac catheterization and CT scan and number of artery stenosis, we divided 222 patients whom had cardiovascular disease into 3 group. We also recorded the periodontal status including the numbers of missing tooth, probing depth, clinical attachment loss, bleeding on probing and plaque record. Single nucleotide polymorphisms were based on samples of IL-6 -572 (rs1800796), IL-10 -592 (rs1800872), 9P21.3 (rs10757278) gene polymorphism analysis. The relationship between single nucleotide polymorphisms, periodontitis and cardiovascular disease were analysed.
Result:
Three artery stenosis group had more tooth loss, higher average loss of clinical attachment level and higher level of clinical attachment loss ≧ 5 mm percentage. There were statistically significantly higher levels of clinical attachment loss and loss of clinical attachment level ≧ 5 mm percentage in group whom with history of myocardial infarction than that with no history of myocardial infarction.IL-6 -572 G genotype has a protective effect on severity of periodontoitis and gender, history of diabetes, pack-year> 30 had statistically significantly association with heart artery stenosis. But single nucleotide polymorphisms did not reach a statistically significant correlation with heart artery stenosis.
Conclusion:
The results indicated that there were more advanced periodontal breakdown in more artery stenosis group and with history of myocardial infarction group.IL-6 -572 G genotype has a protective effect on severity of periodontitis but single nucleotide polymorphism did not reach a statistically significant correlation with severity of more artery stenosis and with history of myocardial infarction.

並列關鍵字

periodontitis ； cardiac artery stenosis ； gene polymorphism

參考文獻

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