Chang Kuang-Hsi, Hsu Yi-Chao, Chiu Ing-Ming, Chen Lih-Chyang, Hsu Chih-Chao, Lee Chang-Yin, Fan Hueng-Chuen, Chen Hsuan-Ju, Chou Ruey-Hwang
Department of Medical Research.
Graduate Institute of Biomedical Sciences, China Medical University.
Medicine (Baltimore). 2020 Jul 31;99(31):e21423. doi: 10.1097/MD.0000000000021423.
Whether periodontitis is a risk factor for developing bipolar disorders (BD) has not been investigated. We aimed to determine whether periodontitis is associated with the subsequent development of BD and examine the risk factors for BD among patients with periodontitis.Using ambulatory and inpatient claims data from the National Health Insurance Research Database (NHIRD), we identified 12,337 patients who were aged at least 20 years and newly diagnosed with periodontitis between 2000 and 2004. The date of the first claim with a periodontitis diagnosis was set as the index date. For each patient with periodontitis, 4 subjects without a history of periodontitis were randomly selected from the NHIRD and frequency-matched with the patients with periodontitis according to sex, age (in 5-year bands), and index year.The periodontitis group had a mean age of 44.0 ± 13.7 years and slight predominance of men (51.3%). Compared with the subjects without periodontitis, the patients with periodontitis had higher prevalence of diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, stroke, head injury, major depressive disorder, chronic obstructive pulmonary disease (COPD), and asthma (P < .001). The incidence rate of BD was higher in the periodontitis group than in the non-periodontitis group (2.74 vs 1.46 per 1000 person-year), with an adjusted hazard ratio of 1.82 (95% confidence interval = 1.59-2.08) after adjustment for sex, age, and comorbidities.The patients with periodontitis exhibited a significantly higher risk of developing BD. Keep the better oral hygiene to reduce periodontitis might be a preventive strategy for BD.
牙周炎是否为双相情感障碍（BD）发病的危险因素尚未得到研究。我们旨在确定牙周炎是否与BD的后续发病相关，并探讨牙周炎患者中BD的危险因素。利用国民健康保险研究数据库（NHIRD）的门诊和住院理赔数据，我们识别出12337名年龄至少20岁且在2000年至2004年间新诊断为牙周炎的患者。首次诊断为牙周炎的理赔日期被设定为索引日期。对于每位牙周炎患者，从NHIRD中随机选取4名无牙周炎病史的受试者，并根据性别、年龄（按5岁分组）和索引年份与牙周炎患者进行频率匹配。牙周炎组的平均年龄为44.0±13.7岁，男性略占优势（51.3%）。与无牙周炎的受试者相比，牙周炎患者患糖尿病、高脂血症、高血压、缺血性心脏病、中风、头部损伤、重度抑郁症、慢性阻塞性肺疾病（COPD）和哮喘的患病率更高（P<0.001）。牙周炎组BD的发病率高于非牙周炎组（每1000人年分别为2.74和1.46），在对性别、年龄和合并症进行调整后，调整后的风险比为1.82（95%置信区间=1.59-2.08）。牙周炎患者发生BD的风险显著更高。保持更好的口腔卫生以减少牙周炎可能是预防BD的一种策略。
