Artificial Intelligence Big Data Medical Center, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Korea.
Int Dent J. 2021 Dec;71(6):516-521. doi: 10.1016/j.identj.2021.01.006. Epub 2021 Mar 24.
The intent was to analyse the association of periodontitis with the development of rheumatoid arthritis (RA) using a representative population-based cohort and longitudinal matched-cohort design.
Participants were 40 years of age or older and had not been diagnosed with RA between 2002 and 2006. Among the participants, those who were newly diagnosed with periodontitis between 2004 and 2006 (excluding cases that had already been diagnosed with periodontitis between 2002 and 2003) were allotted to the periodontitis group. Among the participants, those who had never been diagnosed with periodontitis between 2002 and 2006 formed the control group, matched by sex, age, and household income at a 1:1 ratio. From 2007 to 2018, the 2 groups (n = 691,506) were followed to monitor the development of RA. The t-test and χ test compared the general characteristics and health-related variables of both groups. The Kaplan-Meier method with a log-rank test was conducted to compare the incidence of RA in both groups. The hazard ratio (HR) and adjusted hazard ratio (aHR) were calculated using a Cox proportional hazard regression analysis to evaluate the risk of subsequent RA.
Univariate analysis revealed that the periodontitis group was more likely to develop RA than the control group (hazard ratio 1.10), and multivariate analysis also revealed a higher incidence risk of RA (adjusted hazard ratio 1.09) in the periodontitis group.
Our findings demonstrate that periodontitis is associated with an increased risk of developing RA.
本研究旨在采用具有代表性的基于人群的队列研究和纵向匹配队列设计，分析牙周炎与类风湿关节炎（RA）发展之间的关联。
研究对象为年龄在 40 岁及以上且在 2002 年至 2006 年期间未被诊断患有 RA 的人群。在这些参与者中，于 2004 年至 2006 年期间新诊断为牙周炎（排除 2002 年至 2003 年期间已被诊断为牙周炎的病例）的患者被分配到牙周炎组。在这些参与者中，从未在 2002 年至 2006 年期间被诊断为牙周炎的患者作为对照组，按照性别、年龄和家庭收入以 1:1 的比例进行匹配。从 2007 年至 2018 年，对两组（n=691506）进行随访，以监测 RA 的发生情况。采用 t 检验和 χ 检验比较两组的一般特征和健康相关变量。采用 Kaplan-Meier 方法和对数秩检验比较两组的 RA 发生率。采用 Cox 比例风险回归分析计算风险比（HR）和调整后的风险比（aHR），以评估随后发生 RA 的风险。
单因素分析显示，牙周炎组发生 RA 的风险高于对照组（HR 1.10），多因素分析也显示牙周炎组发生 RA 的风险较高（调整后的 HR 1.09）。
本研究结果表明，牙周炎与发生 RA 的风险增加相关。
