Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
Rheumatology (Oxford). 2024 Apr 2;63(4):1084-1092. doi: 10.1093/rheumatology/kead345.
To investigate the association between periodontal disease and the development of inflammatory arthritides in the general population.
In total, 489 125 participants from the UK Biobank without a previous history of RA, AS and PsA were enrolled. The primary outcome was the incidence of inflammatory arthritides, which was a composite of RA, AS and PsA according to the presence of periodontal disease based on self-reported oral health indicators. Multivariate Cox proportional hazard regression analyses using four different models were performed to assess the association between periodontal disease and inflammatory arthritides development.
In all, 86 905 and 402 220 individuals were categorized as with and without periodontal disease, respectively. Cox hazard analysis indicated that the presence of periodontal disease was an independent predictor of the occurrence of composite outcomes of inflammatory arthritides, which was also consistent for RA and AS. Significant associations were found to be consistent in the four Cox models and were replicated even when different criteria were used to define periodontal disease. Subgroup analyses indicated that periodontal disease was associated with an increased RA risk in those aged <60 years, and this risk was persistent for both male and female patients and for patients with seropositive/seronegative RA.
Self-reported periodontal disease is associated with inflammatory arthritides incidence in participants included in the UK Biobank, particularly for RA and AS. Higher clinical attention and optimal dental care in patients with signs of periodontal disease may be recommended for early disease detection and for reducing this risk.
探讨牙周病与普通人群炎症性关节炎发展之间的关联。
共纳入英国生物库中 489125 名无 RA、AS 和 PsA 既往病史的参与者。主要结局是炎症性关节炎的发病率,根据自我报告的口腔健康指标,将牙周病作为 RA、AS 和 PsA 的综合指标。采用四种不同模型的多变量 Cox 比例风险回归分析来评估牙周病与炎症性关节炎发展之间的关联。
共有 86905 人和 402220 人分别归类为有牙周病和无牙周病。Cox 危险分析表明,牙周病的存在是炎症性关节炎复合结局发生的独立预测因素,RA 和 AS 也是如此。四种 Cox 模型均显示出显著相关性,即使使用不同的标准来定义牙周病,结果也具有一致性。亚组分析表明,牙周病与年龄<60 岁的 RA 风险增加有关,这种风险在男性和女性患者以及 RA 血清阳性/阴性患者中均持续存在。
在英国生物库参与者中,自我报告的牙周病与炎症性关节炎的发病率有关,特别是与 RA 和 AS 有关。对于有牙周病迹象的患者,应给予更高的临床关注和最佳的口腔护理,以便早期发现疾病并降低这种风险。