上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (2): 136-141.doi: 10.19439/j.sjos.2026.02.004

• 论著 • 上一篇    下一篇

牙周慢性炎症对大脑皮质脊髓束微结构完整性影响的因果效应分析

王瑞清, 金钰, 刘宬孝, 郭伟明, 房兵   

  1. 上海交通大学医学院附属第九人民医院 口腔正畸科,上海交通大学口腔医学院,国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2025-03-04 修回日期:2025-04-14 出版日期:2026-04-25 发布日期:2026-04-27
  • 通讯作者: 房兵,E-mail：fangbing@sjtu.edu.cn
  • 作者简介:王瑞清（1989—）,男,硕士研究生,E-mail：wangrq@sjtu.edu.cn

Causal impact of chronic periodontitis on brain corticospinal tract microstructures

Wang Ruiqing, Jin Yu, Liu Chengxiao, Guo Weiming, Fang Bing   

  1. Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2025-03-04 Revised:2025-04-14 Online:2026-04-25 Published:2026-04-27

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摘要： 目的:探讨牙周炎（periodontitis, PD）导致特定白质纤维束结构损伤,尤其是运动功能相关的皮质脊髓束（corticospinal tract, CST）微结构异常改变的因果效应。方法:基于PD（45 563例样本）和CST影像学衍生表型（imaging-derived phenotypes, IDPs, 31 356例样本）的全基因组关联研究（genome wide association study, GWAS）数据,开展双样本孟德尔随机化分析（Mendelian randomization, MR）。采用逆方差加权（inverse variance weighted, IVW）方法进行分析,辅以加权中位数法（weighted median, WM）、MR-Egger回归、稳健调整特征评分法（robust adjusted profile score, MR-RAPS）和约束最大似然及模型平均贝叶斯信息准则（constrained maximum likelihood and model averaging bayesian information criterion, cML）。采用Cochran Q检验、多效性残差与离群值检测方法（Mendelian randomization pleiotropy residual sum and outlier,MR-PRESSO）和留一法（leave-one-out, LOO）进行敏感性分析。结果:PD与CST的各向异性分数（fractional anisotropy, FA）呈正相关（β=0.07, P=6.11×10-3）,与平均扩散率（mean diffusivity, MD）呈负相关（β=-0.06, P=3.90×10-2）。敏感性分析结果保持一致。PD引起CST中FA值增加和MD降低,CST的完整性受到病变影响。结论:PD对CST微结构完整性病变有因果影响,可能增加CST微结构损伤的风险。提示在临床实践中,有必要对PD进行早期干预和系统治疗。

关键词: 牙周炎, 皮质脊髓束, 影响学衍生表型, 孟德尔随机化

Abstract: PURPOSE: To investigate whether periodontitis (PD) induces microstructural alterations in specific WM tracts, particularly the corticospinal tract (CST), which is associated with motor function. METHODS: Based on genome wide association study (GWAS) summary statistics from PD (45 563 samples) and CST imaging-derived phenotypes (IDPs) (31 356 samples), two-sample Mendelian randomization (MR) analysis was performed. The primary analysis was conducted using inverse variance weighted (IVW) method, supplemented by weighted median (WM), MR-Egger regression, robust adjusted profile score (MR-RAPS), and constrained maximum likelihood and model averaging bayesian information criterion (cML). Sensitivity analysis was performed using Cochran Q test, Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO), and leave-one-out (LOO) analysis. Results: MR analysis revealed positive associations between PD and CST fractional anisotropy (FA)(β=0.07, P=6.11×10-3) and negative associations with mean diffusivity (MD)(β=-0.06, P=3.90×10-2). These findings remained consistent across sensitivity analysis. PD led to an increase in FA values and a decrease in MD within the CST, indicating that the integrity of the CST was compromised. CONCLUSIONS: PD has a detrimental causal impact on the integrity of CST microstructures, potentially increasing the risk of CST lesions. Therefore, this study suggests that effective clinical prevention and treatment of PD are necessary.

Key words: Periodontitis, Corticospinal tract, Imaging-derived phenotypes, Mendelian randomization

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