Association between serum IgG titers to periodontal pathogens and outcomes for ischemic stroke patients / 中华老年医学杂志

ABSTRACT

Objective:To explore the relationship between serum IgG titers to periodontal pathogens and the modified Rankin Score(mRS)after a 3-month follow-up of older patients with ischemic stroke.Methods:Data on 379 older patients diagnosed with ischemic stroke at the Third Affiliated Hospital of Soochow University from January 2019 to April 2020 were retrospectively analyzed.Basic patient data and laboratory test results were collected.Serum samples were collected within three days after the stroke, and serum IgG antibody titers to 9 periodontal pathogens were detected.Patients were followed up for 3 months and the m-RS was calculated.Results:Among the 379 patients, 104(27.4%)had an mRS score ≥ 3 at 3-months.Univariate analysis after adjusting for age and sex showed that atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, the National Institutes of Health Stroke Scale(NIHSS)score, and C-reactive protein(CRP)levels were all risk factors for unfavorable 3-month outcomes(all P<0.05). After fully adjusting confounding factors including age, sex, atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, NIHSS score and CRP level at hospital admission, only the serum IgG antibody titer to Fusobacterium nucleatum increased the risk of unfavorable 3-month outcomes out of titers to 9 periodontal pathogens, and the odds ratio( OR)per standard deviation increase in titer was 3.01(95% CI 1.73-5.23, P<0.001). Curve fitting showed that the relationship between serum IgG antibody titers to Fusobacterium nucleatum and unfavorable 3-month outcomes was close to a positive linear correlation( χ2=15.333, P<0.001). Stratified analysis showed that there were no subgroup variables, including smoking and drinking habits, comorbidities(hypertension, diabetes, dyslipidemia, chronic kidney disease), and the history of stroke, significantly changed the association between serum IgG antibody titers to Fusobacterium nucleatum and poor prognosis( Pvalues for the interaction were 0.985, 0.708, 0.388, 0.903, 0.613, 0.700, 0.611). Conclusions:Serum IgG antibody titers to Fusobacterium nucleatum are independently correlated with unfavorable 3-month outcomes in older ischemic stroke patients.The higher the antibody titer, the greater the risk of adverse outcomes.