The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China.
The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Parkinsons Dis. 2023;13(7):1107-1125. doi: 10.3233/JPD-230059.
Multiple observational studies have yielded controversial results regarding the association between Parkinson's disease (PD) and periodontitis.
This systematic review and meta-analysis was conducted to ascertain their bidirectional relationship.
A literature search for relevant studies was performed in PubMed, EMBASE, the Cochrane Library, and Web of Science databases from inception to December 19, 2022. Effect sizes (ES) with 95% confidence intervals were pooled under the random-effects model. Then, leave-one-out sensitivity analysis and contour-enhanced funnel plot were applied to assess the stability of the results.
A total of 34 studies and 24 studies were included for systematic review and quantitative meta-analysis, respectively. Pooled ES indicated that periodontitis was not significantly associated with PD risk (HR = 1.13, 95% CI 0.88-1.45, n = 3; OR = 1.94, 95% CI 0.55-6.90, n = 7), while the Mendelian randomization study revealed no association between PD and periodontitis risk (coefficient [B] = -0.0001, standard error = 0.0001, p = 0.19). Furthermore, PD patients exhibited higher levels of periodontal pocket depth (SMD = 1.10, 95% CI 0.53-1.67), clinical attachment level (SMD = 1.40, 95% CI 0.55-2.26), plaque index (SMD = 0.81, 95% CI 0.22-1.39), and Oral Health Impact Profile-14 score (SMD = 0.91, 95% CI 0.33-1.49) compared to healthy controls.
Our meta-analysis identified no bidirectional association between PD risk and periodontitis risk, though the prevalence of periodontitis and poorer oral status was higher in PD patients.
多项观察性研究对帕金森病 (PD) 与牙周炎之间的关联得出了相互矛盾的结果。
本系统评价和荟萃分析旨在确定它们之间的双向关系。
从建库至 2022 年 12 月 19 日，在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库中进行了相关研究的文献检索。使用随机效应模型汇总具有 95%置信区间的效应大小 (ES)。然后，采用逐一剔除敏感性分析和等高线增强漏斗图评估结果的稳定性。
共纳入 34 项研究进行系统评价和定量荟萃分析。汇总的 ES 表明，牙周炎与 PD 风险无显著相关性（HR=1.13，95%CI 0.88-1.45，n=3；OR=1.94，95%CI 0.55-6.90，n=7），而孟德尔随机化研究表明 PD 与牙周炎风险之间无关联（系数 [B]=-0.0001，标准误差 [SE]=0.0001，p=0.19）。此外，与健康对照组相比，PD 患者的牙周袋深度（SMD=1.10，95%CI 0.53-1.67）、临床附着丧失水平（SMD=1.40，95%CI 0.55-2.26）、菌斑指数（SMD=0.81，95%CI 0.22-1.39）和 Oral Health Impact Profile-14 评分（SMD=0.91，95%CI 0.33-1.49）更高。
本荟萃分析未发现 PD 风险与牙周炎风险之间存在双向关联，尽管 PD 患者的牙周炎患病率和口腔状况较差。
