Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan.
Eur J Neurol. 2013 Jul;20(7):1053-9. doi: 10.1111/ene.12103. Epub 2013 Feb 9.
The pathogenesis of multiple sclerosis (MS) is still not fully understood, but multiple infections are known to be crucial in the development of the disease. Periodontitis caused by periodontopathic polymicrobial infections is among the most common chronic infectious disorders. This case-control study aimed to investigate the association between chronic periodontitis (CP) and MS using a population-based dataset in Taiwan.
This study included 316 cases who had a diagnosis of MS and 1580 randomly selected controls. We performed conditional logistic regressions to investigate the association between MS and having been previously diagnosed with CP.
The results reveal that the prevalence of earlier CP was 25.6% and 15.4% for cases and controls, respectively (P < 0.001). Conditional logistic regression analysis revealed that cases were 1.86 [95% confidence interval (CI) = 1.39-2.48] times as likely as controls to have been previously diagnosed with CP, after adjusting for sociodemographic characteristics as well as hyperlipidemia, hypertension, coronary heart disease, alcohol abuse/alcohol-dependence syndrome, tobacco use disorder and chronic obstructive pulmonary disease. After analyzing by gender, it was realized that while female cases had a higher chance than female controls of having earlier CP (adjusted odds ratio = 2.08; 95% CI = 1.49-2.95), there was no statistical association detected between these two conditions in men.
This study provides evidence for an association between CP and MS in female, but not male, subjects. Further epidemiological studies are needed to confirm the association and gender-specific differences found in the present study.
多发性硬化症（MS）的发病机制尚不完全清楚，但已知多种感染在疾病的发展中起着关键作用。由牙周病多微生物感染引起的牙周炎是最常见的慢性感染性疾病之一。本病例对照研究旨在使用台湾的基于人群的数据集调查慢性牙周炎（CP）与 MS 之间的关联。
本研究纳入了 316 例 MS 患者和 1580 名随机选择的对照者。我们进行了条件逻辑回归分析，以调查 MS 与先前被诊断为 CP 之间的关联。
结果显示，病例组和对照组的早期 CP 患病率分别为 25.6%和 15.4%（P<0.001）。条件逻辑回归分析显示，在调整社会人口特征以及高血脂、高血压、冠心病、酒精滥用/酒精依赖综合征、烟草使用障碍和慢性阻塞性肺疾病后，病例组发生 CP 的可能性是对照组的 1.86 倍（95%置信区间[CI]：1.39-2.48）。按性别分析后发现，女性病例发生 CP 的可能性高于女性对照（校正比值比=2.08；95%CI：1.49-2.95），但在男性中未发现这两种情况之间存在统计学关联。
本研究为 CP 与 MS 之间的关联提供了证据，这种关联仅存在于女性，而不存在于男性中。需要进一步的流行病学研究来证实本研究中发现的关联和性别差异。
