Wu Yi-Da, Lin Ching-Heng, Chao Wen-Cheng, Liao Tsai-Ling, Chen Der-Yuan, Chen Hsin-Hua
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
PLoS One. 2017 Oct 23;12(10):e0187075. doi: 10.1371/journal.pone.0187075. eCollection 2017.
To examine the association between a history of periodontitis (PD) and incident systemic lupus erythematosus (SLE).
We used 2003-2012 claims data from the Taiwanese National Health Insurance Database to identify 7,204 incident SLE patients during 2007-2012 as the study group, along with randomly selecting 72,040 non-SLE patients matched (1:10) for age, gender, and first diagnosis date (index date) as the control group. The correlation between PD and SLE risk was estimated using conditional logistic regression analysis, after making adjustments for confounders (including a history of diabetes and number of non-PD related dental visits before the index date). To evaluate the effects of PD severity and the lag time which occurred since the last PD visit on SLE development, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for subgroups of patients with PD according to their number of visits, cumulative cost and also the time gaps between their last PD-related visit and the index date.
A statistically significant association between a history of PD and newly diagnosed SLE was observed (OR, 1.21; 95% CI, 1.14-1.28; p-value, <0.001). The association was both dose- and time-dependent and was found to be strongest when the interval between the last PD-related visit and the index date was less than three months (OR, 1.83; 95% CI, 1.61-2.09; p-value, <0.001). The association between PD exposure and SLE risk was consistently significant among subgroups stratified based on age, gender, or DM status.
The results of this nationwide, population-based, case-control study suggest that there is a significant association between a history of PD and incident SLE in Taiwan. This weak association is limited to lack of information on individual smoking status in the database.
研究牙周炎（PD）病史与新发系统性红斑狼疮（SLE）之间的关联。
我们使用了台湾国民健康保险数据库2003 - 2012年的理赔数据，将2007 - 2012年期间确诊的7204例新发SLE患者作为研究组，并随机选取72040例年龄、性别和首次诊断日期（索引日期）相匹配（1:10）的非SLE患者作为对照组。在对混杂因素（包括糖尿病史和索引日期前非PD相关牙科就诊次数）进行调整后，使用条件逻辑回归分析估计PD与SLE风险之间的相关性。为了评估PD严重程度以及自上次PD就诊以来的滞后时间对SLE发病的影响，根据PD患者的就诊次数、累计费用以及上次PD相关就诊与索引日期之间的时间间隔，计算了95%置信区间（CI）的比值比（OR）。
观察到PD病史与新诊断的SLE之间存在统计学显著关联（OR，1.21；95% CI，1.14 - 1.28；p值，<0.001）。该关联具有剂量和时间依赖性，并且在最后一次PD相关就诊与索引日期之间的间隔小于三个月时最强（OR，1.83；95% CI，1.61 - 2.09；p值，<0.001）。在按年龄、性别或糖尿病状态分层的亚组中，PD暴露与SLE风险之间的关联始终显著。
这项基于全国人群的病例对照研究结果表明，台湾地区PD病史与新发SLE之间存在显著关联。这种弱关联仅限于数据库中缺乏个体吸烟状况的信息。
