Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
J Clin Periodontol. 2013 May;40(5):474-82. doi: 10.1111/jcpe.12086. Epub 2013 Mar 15.
To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses.
This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders.
Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30-1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22-1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10-1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07-1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06-1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32-7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05-2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse.
This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records.
利用电子病历和牙科记录的关联,在无先验假设的情况下发现牙周炎与疾病之间的关联。
这项病例对照研究纳入了 2475 名在哥伦比亚大学牙科医学院接受牙科治疗和纽约长老会医院接受医疗治疗的患者。我们的病例是接受牙周治疗的患者,对照组是接受牙科维护但未接受牙周治疗的患者。采用卡方分析医疗治疗代码,并采用逻辑回归调整混杂因素。
我们的方法在一个主要为西班牙裔的人群中复制了一些重要的牙周炎关联,包括 1 型糖尿病(OR=1.6,95%CI 1.30-1.99,p<0.001)和 2 型糖尿病(OR=1.4,95%CI 1.22-1.67,p<0.001)、高血压(OR=1.2,95%CI 1.10-1.37,p<0.001)、高胆固醇血症(OR=1.2,95%CI 1.07-1.38,p=0.004)、高脂血症(OR=1.2,95%CI 1.06-1.43,p=0.008)和与妊娠及分娩相关的疾病(OR=2.9,95%CI:1.32-7.21,p=0.014)。在调整年龄、性别、种族、高血压、糖尿病、肥胖、脂质和循环系统疾病、酒精和烟草滥用等因素后,我们还发现了与良性前列腺增生的先前未报告的关联(OR=1.5,95%CI 1.05-2.10,p=0.026)。
本研究利用电子病历的关联提供了一种高通量的方法来将牙周炎与系统性疾病相关联。