Article Text
Abstract
Objectives To identify the association between periodontal diseases (gingivitis and periodontitis) and chronic diseases including cardiovascular disease, cardiometabolic disease, autoimmune disease and mental ill health.
Design Retrospective cohort.
Setting IQVIA Medical Research Data-UK between 1 January 1995 and 1 January 2019.
Participants 64 379 adult patients with a general practitioner recorded diagnosis of periodontal disease (exposed patients) were matched to 251 161 unexposed patients by age, sex, deprivation and registration date.
Main outcome measures Logistic regression models accounting for covariates of clinical importance were undertaken to estimate the adjusted OR (aOR) of having chronic diseases at baseline in the exposed compared with the unexposed group. Incidence rates for each outcome of interest were then provided followed by the calculation of adjusted HRs using cox regression modelling to describe the risk of outcome development in each group.
Results The average age at cohort entry was 45 years and the median follow-up was 3.4 years. At study entry, the exposed cohort had an increased likelihood of having a diagnosis of cardiovascular disease (aOR 1.43; 95% CI 1.38 to 1.48), cardiometabolic disease (aOR 1.16; 95% CI 1.13 to 1.19), autoimmune disease (aOR 1.33; 95% CI 1.28 to 1.37) and mental ill health (aOR 1.79; 95% CI 1.75 to 1.83) compared with the unexposed group. During the follow-up of individuals without pre-existing outcomes of interest, the exposed group had an increased risk of developing cardiovascular disease (HR 1.18; 95% CI 1.13 to 1.23), cardiometabolic disease (HR 1.07; 95% CI 1.03 to 1.10), autoimmune disease (HR 1.33; 95% CI 1.26 to 1.40) and mental ill health (HR 1.37; 95% CI 1.33 to 1.42) compared with the unexposed group.
Conclusions In this cohort, periodontal diseases appeared to be associated with an increased risk of developing cardiovascular, cardiometabolic, autoimmune diseases and mental ill health. Periodontal diseases are very common; therefore, an increased risk of other chronic diseases represent a substantial public health burden.
- epidemiology
- health informatics
- oral medicine
- public health
Data availability statement
Data may be obtained from a third party and are not publicly available. The full data-set and statistical analysis code following receipt of ethics approval are available from author JSC (joht.chandan@nhs.net).
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data may be obtained from a third party and are not publicly available. The full data-set and statistical analysis code following receipt of ethics approval are available from author JSC (joht.chandan@nhs.net).
Supplementary materials
Supplementary Data
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Footnotes
DTZ and JSC are joint first authors.
KR and KN are joint senior authors.
Twitter @Dawit_TZ, @johtchandan, @DrMarieFalahee
Contributors DTZ, JSC, DR, TT, KN and KR conceived the idea for the study. DTZ, KMG and JSC conducted the statistical analysis. DTZ, JSC, DR and ADR were responsible for the initial draft of the report. KMG, TT, MF, PDP, JML, KR and KN contributed to subsequent drafts and all authors were involved in the final draft. KR and KN were responsible for supervision. JSC acts as guarantor for the final manuscript.
Funding This paper represents independent research part funded by the MRC Versus Arthritis Centre for Musculoskeletal Ageing Research. KR and JL are supported by the NIHR Birmingham Biomedical Research Centre.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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