Huang Yi-Fang, Chang Chung-Ta, Muo Chih-Hsin, Chiu Kuan-Ming, Tsai Chun-Hao, Liu Shih-Ping
Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan.
School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
Clin Oral Investig. 2021 Nov;25(11):6377-6384. doi: 10.1007/s00784-021-03938-0. Epub 2021 Apr 14.
This study aimed to determine the relation between temporomandibular disorder (TMD) and ankylosing spondylitis (AS) bidirectionally and ascertain the important comorbidities for AS occurrence in TMD patients.
We conducted this population-based cohort study through Longitudinal Health Insurance Database, Taiwan. Study 1 investigated the risk of TMD in AS patients. Study 2 assessed the risk of AS in TMD patients.
In total, 3204 AS patients and 12,816 age-matched and gender-matched comparisons were enrolled in study 1. The TMD incidence in the AS cohort was 2.88-fold higher when compared with the comparisons (1.54 vs. 0.53 per 10,000 person-years). After adjusting for age, gender, and comorbidity, the AS cohort had a 2.66-fold (95% CI = 1.79-3.97) increased risk of TMD occurrence (P < 0.0001). The second study recruited 4998 TMD patients and 19,991 age-matched and gender-matched comparisons. Both TMD and comparison cohorts showed similar AS risk (HR = 1.49, 95% CI = 0.91-2.43, P = 0.1108) in the adjusted model. Study 2 identified a 3.66-fold increased risk of AS occurrence in TMD patients with comorbidity, including parapsoriasis, rheumatoid arthritis, osteoporosis, Cushing's syndrome, and climacteric arthritis (P < 0.012).
AS appears to significantly impact the occurrence of TMD. TMD might play a synergic role in AS development.
Clinicians have to be vigilant about the increased risk of TMD in AS patients and take care of AS disease activity and prognosis. The symptoms and signs of TMD could be a predictor of AS in patients with the aforementioned comorbidities.
本研究旨在双向确定颞下颌关节紊乱病（TMD）与强直性脊柱炎（AS）之间的关系，并确定TMD患者发生AS的重要合并症。
我们通过台湾纵向健康保险数据库进行了这项基于人群的队列研究。研究1调查了AS患者发生TMD的风险。研究2评估了TMD患者发生AS的风险。
研究1共纳入3204例AS患者和12816例年龄及性别匹配的对照。AS队列中TMD的发病率比对照组高2.88倍（每10000人年1.54例 vs. 0.53例）。在调整年龄、性别和合并症后，AS队列发生TMD的风险增加了2.66倍（95%CI = 1.79 - 3.97）（P < 0.0001）。第二项研究招募了4998例TMD患者和19991例年龄及性别匹配的对照。在调整模型中，TMD组和对照组的AS风险相似（HR = 1.49，95%CI = 0.91 - 2.43，P = 0.1108）。研究2发现，合并副银屑病、类风湿关节炎、骨质疏松症、库欣综合征和更年期关节炎等合并症的TMD患者发生AS的风险增加了3.66倍（P < 0.012）。
AS似乎对TMD的发生有显著影响。TMD可能在AS的发展中起协同作用。
临床医生必须警惕AS患者发生TMD的风险增加，并关注AS的疾病活动和预后。TMD的症状和体征可能是上述合并症患者发生AS的预测指标。
