School of Dentistry, China Medical University, Taichung, Taiwan.
Department of Pediatric Dentistry, China Medical University Hospital, Taichung, Taiwan.
Sci Rep. 2020 Oct 16;10(1):17568. doi: 10.1038/s41598-020-74589-6.
Periodontitis is a multifactorial inflammatory disease that can cause tooth loss and contribute to systemic inflammation. It is suggested that periodontitis may be associated with the development of glaucoma. Based on data from Taiwan's National Health Insurance Research Database, a retrospective cohort study was conducted to investigate the risk of developing glaucoma in patients with periodontitis. The periodontitis cohort consisted of newly diagnosed adult patients (n = 194,090, minimum age = 20 years) between 2000 and 2012. The comparison group included age-, gender-, and diagnosis date-matched people without periodontitis (n = 194,090, minimum age = 20 years). Incident glaucoma was monitored until the end of 2013. Hazard ratios (HRs) with confidence intervals (CIs) were established based on the Cox proportional hazard models. The risk of developing glaucoma was higher in patients with periodontitis than those without periodontitis (31.2 vs. 23.3 patients per 10,000 person-years, with an adjusted HR of 1.26 [95% CI 1.21-1.32]). A high risk was evident even after stratifying by age (adjusted HRs = 1.34 [1.26-1.44] for ages 20-49, 1.24 [1.13-1.36] for ages ≥ 65, and 1.20 [1.12-1.29] for ages 50-64 years), sex (adjusted HRs = 1.33 [1.24-1.41] and 1.21 [1.14-1.28] for men and women, respectively), presence of comorbidity (adjusted HRs = 1.38 [1.29-1.47] and 1.18 [1.12-1.25] for without and with comorbidity, respectively), and corticosteroid use (adjusted HRs = 1.27 [1.21-1.33] and 1.21 [1.08-1.35] for without and with corticosteroid use, respectively). Specifically, patients with periodontitis exhibited a significantly high risk of primary open-angle glaucoma (adjusted HR = 1.31 [1.21-1.32]) but not for primary closed-angle glaucoma (adjusted HR = 1.05 [0.94-1.17]). People with periodontitis are at a greater risk of glaucoma than individuals without periodontitis. Ocular health should be emphasized for such patients, and the underlying mechanisms need further investigation.
牙周炎是一种多因素的炎症性疾病，可导致牙齿脱落并引发全身炎症。有研究表明，牙周炎可能与青光眼的发生发展有关。本研究基于台湾全民健康保险研究数据库中的数据，采用回顾性队列研究分析了牙周炎患者发生青光眼的风险。牙周炎队列纳入了 2000 年至 2012 年间新诊断的成年患者（n=194090 例，最小年龄≥20 岁）。对照组为年龄、性别和诊断日期匹配且无牙周炎的人群（n=194090 例，最小年龄≥20 岁）。监测青光眼的发病情况，直至 2013 年底。采用 Cox 比例风险模型确定风险比（HR）及其 95%置信区间（CI）。与无牙周炎者相比，牙周炎患者发生青光眼的风险更高（每 10000 人年中 31.2 例 vs. 23.3 例，校正 HR 为 1.26[95%CI 1.21-1.32]）。即使按年龄（校正 HRs=1.34[1.26-1.44]，年龄 20-49 岁；1.24[1.13-1.36]，年龄≥65 岁；1.20[1.12-1.29]，年龄 50-64 岁）、性别（校正 HRs=1.33[1.24-1.41]和 1.21[1.14-1.28]，男性和女性）、合并症（校正 HRs=1.38[1.29-1.47]和 1.18[1.12-1.25]，无合并症和有合并症）和皮质类固醇使用（校正 HRs=1.27[1.21-1.33]和 1.21[1.08-1.35]，无皮质类固醇使用和有皮质类固醇使用）分层后，这种差异仍然存在。具体而言，牙周炎患者发生原发性开角型青光眼的风险显著升高（校正 HR=1.31[1.21-1.32]），但发生原发性闭角型青光眼的风险无显著升高（校正 HR=1.05[0.94-1.17]）。与无牙周炎者相比，牙周炎患者发生青光眼的风险更高。此类患者应重视眼部健康，其潜在发病机制仍需进一步研究。
