牙周炎患者年龄相关性黄斑变性的风险：一项全国基于人群的队列研究。
RISK OF AGE-RELATED MACULAR DEGENERATION IN PATIENTS WITH PERIODONTITIS: A Nationwide Population-Based Cohort Study.
机构信息
School of Dentistry, College of Dentistry, China Medical University, Taichung, Taiwan.
Department of Pediatric Dentistry, China Medical University Hospital, Taichung, Taiwan.
出版信息
Retina. 2020 Dec;40(12):2312-2318. doi: 10.1097/IAE.0000000000002750.
PURPOSE
Periodontitis is an inflammatory disease that results in loss of connective tissue and bone support. Evidence shows a possible relationship between periodontitis and age-related macular degeneration (AMD).
METHODS
This population-based cohort study was conducted using data from the National Health Insurance Research Database in Taiwan, with a 13-year follow-up, to investigate the risk of AMD in patients with periodontitis. The periodontitis cohort included patients with newly diagnosed periodontitis between 2000 and 2012. The nonperiodontitis cohort was frequency-matched with the periodontitis cohort by age and sex, with a sample size of 41,661 in each cohort.
RESULTS
Patients with periodontitis had an increased risk of developing AMD compared with individuals without periodontitis (5.95 vs. 3.41 per 1,000 person-years, adjusted hazard ratio = 1.58 [95% confidence interval, 1.46-1.70]). The risk of developing AMD remained significant after stratification by age (adjusted hazard ratio = 1.48 [1.34-1.64] for age <65 years and 1.76 [1.57-1.97] for age ≥65 years), sex (adjusted hazard ratio = 1.40 [1.26-1.55] for women and 1.82 [1.63-2.04] for men), and presence of comorbidity (adjusted hazard ratio = 1.52 [1.40-1.66] for with comorbidity and 1.92 [1.63-2.26] for without comorbidity). In addition, patients with periodontitis showed an increased incidence for both nonexudative type AMD (5.43 vs. 3.13 per 1,000 person-years) and exudative type AMD (0.52 vs. 0.28 per 1,000 person-years).
CONCLUSION
People with periodontitis could be at a greater risk of developing AMD than those without periodontitis. However, we need more evidence to support this association.
目的
牙周炎是一种导致结缔组织和骨支持丧失的炎症性疾病。有证据表明，牙周炎与年龄相关性黄斑变性（AMD）之间可能存在关联。
方法
本研究采用台湾全民健康保险研究数据库的数据，进行了一项基于人群的队列研究，随访时间为 13 年，旨在调查牙周炎患者患 AMD 的风险。牙周炎队列包括 2000 年至 2012 年间新诊断为牙周炎的患者。非牙周炎队列按年龄和性别与牙周炎队列进行频数匹配，每个队列的样本量为 41661 人。
结果
与无牙周炎者相比，患有牙周炎的患者发生 AMD 的风险增加（每 1000 人年 5.95 例 vs. 3.41 例，调整后的危险比=1.58[95%置信区间，1.46-1.70]）。按年龄分层（年龄<65 岁时调整后的危险比=1.48[1.34-1.64]，年龄≥65 岁时调整后的危险比=1.76[1.57-1.97]）、性别（女性调整后的危险比=1.40[1.26-1.55]，男性调整后的危险比=1.82[1.63-2.04]）和是否存在合并症（有合并症时调整后的危险比=1.52[1.40-1.66]，无合并症时调整后的危险比=1.92[1.63-2.26]）后，发生 AMD 的风险仍显著增加。此外，牙周炎患者发生非渗出性 AMD 的发病率也较高（每 1000 人年 5.43 例 vs. 3.13 例），渗出性 AMD 的发病率也较高（每 1000 人年 0.52 例 vs. 0.28 例）。
结论
患有牙周炎的人比没有牙周炎的人患 AMD 的风险更高。然而，我们需要更多的证据来支持这一关联。
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