利用日本国民健康保险索赔和特定健康检查数据库研究牙齿数量与阿尔茨海默病的相关性。
Association between number of teeth and Alzheimer's disease using the National Database of Health Insurance Claims and Specific Health Checkups of Japan.
机构信息
Japan Dental Association Research Institute, Tokyo, Japan.
Department of Dental Sociology, Kanagawa Dental University, Yokosuka, Japan.
出版信息
PLoS One. 2021 Apr 30;16(4):e0251056. doi: 10.1371/journal.pone.0251056. eCollection 2021.
Associations of numbers of teeth present and of missing teeth with Alzheimer's disease were cross-sectionally analyzed using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Dental care claims data of patients aged 60 years or older diagnosed with periodontitis (n = 4,009,345) or missing teeth (n = 662,182) were used to obtain information about the numbers of teeth present and of missing teeth, respectively, and they were combined with medical care claims data including the diagnosis of Alzheimer's disease. Numbers of teeth present and of missing teeth excluding third molars were calculated using the dental formula in the claims for periodontitis and missing teeth, respectively, and categorized into three groups each. Percentages of subjects treated for Alzheimer's disease with 20-28, 10-19, and 1-9 teeth present were 1.95%, 3.87%, and 6.86%, respectively, in patients diagnosed as having periodontitis, and those treated for Alzheimer's disease with 1-13, 14-27, and 28 missing teeth were 2.67%, 5.51%, and 8.70%, respectively, in patients diagnosed as having missing teeth. Logistic regression models using treatment for Alzheimer's disease as an outcome variable and adjusting for age and sex showed that odds ratios (95% confidence intervals) for patients with 10-19 and 1-9 teeth (reference: 20-28 teeth) were 1.11 (1.10-1.13) and 1.34 (1.32-1.37), respectively, (p<0.001), in patients diagnosed as having periodontitis, and odds ratios (95% confidence intervals) for patients with 14-27 missing teeth and 28 missing teeth (reference: 1-13 missing teeth) were 1.40 (1.36-1.44) and 1.81 (1.74-1.89), respectively, (p<0.001), in patients diagnosed as having missing teeth. In conclusion, the results of the present study using Japanese dental claims data showed that older people visiting dental offices with fewer teeth present and a greater number of missing teeth are more likely to have Alzheimer's disease.
本研究利用日本牙科保险理赔和特定健康检查数据库，对现齿数和缺齿数与阿尔茨海默病的相关性进行了横断面分析。利用年龄在 60 岁及以上、被诊断为牙周炎（n=4009345）或缺牙（n=662182）的患者的牙科护理理赔数据，分别获得现齿数和缺齿数的信息，并将其与包括阿尔茨海默病诊断在内的医疗护理理赔数据相结合。使用牙周炎和缺牙理赔中的牙科公式分别计算现齿数和缺齿数（不包括第三磨牙），并将其各自分为三组。在被诊断为牙周炎的患者中，现齿数为 20-28、10-19 和 1-9 颗的患者中，治疗阿尔茨海默病的比例分别为 1.95%、3.87%和 6.86%；在被诊断为缺牙的患者中，缺牙数为 1-13、14-27 和 28 颗的患者中，治疗阿尔茨海默病的比例分别为 2.67%、5.51%和 8.70%。以治疗阿尔茨海默病为因变量的逻辑回归模型，调整年龄和性别后，现齿数为 10-19 和 1-9 颗（参考：20-28 颗）的患者比值比（95%置信区间）分别为 1.11（1.10-1.13）和 1.34（1.32-1.37）（p<0.001），在被诊断为牙周炎的患者中；在被诊断为缺牙的患者中，缺牙数为 14-27 颗和 28 颗的患者比值比（95%置信区间）分别为 1.40（1.36-1.44）和 1.81（1.74-1.89）（p<0.001）。综上所述，本研究使用日本牙科理赔数据的结果表明，去看牙医的老年人现齿数越少、缺牙数越多，患阿尔茨海默病的可能性就越高。
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