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Risk of chronic periodontitis in patients with obstructive sleep apnea in Korea: a nationwide retrospective cohort study
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Seon-Rye Kim, Minkook Son, Yu-Rin Kim
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Epidemiol Health. 2023;45:e2023032. Published online March 6, 2023
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DOI: https://doi.org/10.4178/epih.e2023032
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 Abstract
Summary
 PDF Supplementary Material
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Abstract
OBJECTIVES
The aim of this study was to determine whether the development of chronic periodontitis is more likely among patients who have been newly diagnosed with obstructive sleep apnea (OSA) through an analysis of representative data from the general population.
METHODS A nationwide, population-based, retrospective cohort study was conducted using patient records from the Korean National Health Insurance Service database. For the period 2004-2019, patient data were categorized into 2 groups: a diagnosis of OSA (747 subjects) and no diagnosis of OSA (1,494 subjects). Subsequently, 1:2 propensity score matching was performed to ensure the homogeneity of the 2 groups. To analyze the risk of incident chronic periodontitis, a Cox proportional-hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS In the Kaplan-Meier curve, the disease-free probability was significantly lower in the OSA group than in the non-OSA group (p for log-rank test=0.001). The crude HR for the association between OSA and chronic periodontitis was 1.29 (95% CI, 1.16 to 1.43). The multivariable-adjusted HR was calculated at 1.28 (95% CI, 1.15 to 1.42).
CONCLUSIONS This study confirmed a relationship between OSA and chronic periodontitis. Therefore, OSA patients require oral care to prevent the progression of chronic periodontitis from mild to severe.
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Summary
Korean summary
폐쇄성수면무호흡증 환자의 만성치주염 발생위험 차이를 분석한 결과, 폐쇄성수면무호흡증 그룹에서 만성치주염의 발생위험이 높았다. 따라서 폐쇄성수면무호흡증 환자의 만성치주염 초기치료 및 질환의 진행이 되지 않도록 전문가의 효과적인 구강관리가 필요할 것이다.
Key Message
As a result of analyzing the difference in the risk of chronic periodontitis among patients with obstructive sleep apnea, the risk of chronic periodontitis was higher in the obstructive sleep apnea group. Therefore, effective oral care by experts will be necessary to prevent the initial treatment of chronic periodontitis and progression of the disease in patients with obstructive sleep apnea.
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The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database
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Seon-Rye Kim, Minkook Son, Yu-Rin Kim
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Epidemiol Health. 2022;44:e2022055. Published online July 5, 2022
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DOI: https://doi.org/10.4178/epih.e2022055
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.
METHODS Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.
RESULTS In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.
CONCLUSIONS Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
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Summary
Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.
Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.
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Citations
Citations to this article as recorded by  - Association between statin compliance and risk of dementia among patients with chronic periodontitis
Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
Oral Diseases.2023;[Epub] CrossRef - Impact of statin treatment on cardiovascular events in patients with retinal vein occlusion: a nested case-control study in Korea
Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
Epidemiology and Health.2023; 45: e2023035. CrossRef
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Risk of dementia according to the severity of chronic periodontitis in Korea: a nationwide retrospective cohort study
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Seon-Rye Kim, Minkook Son, Yu-Rin Kim, Hyun-Kyung Kang
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Epidemiol Health. 2022;44:e2022077. Published online September 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022077
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7,032
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280
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3
Web of Science
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3
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
We investigated the risk of dementia in older adults with chronic periodontitis according to the severity of periodontitis.
METHODS Data on patients with chronic periodontitis were extracted from the National Health Insurance Service-Senior cohort database from 2002 to 2014. Among 52,728 subjects eligible for inclusion, 11,953 subjects had newly diagnosed mild chronic periodontitis (MCP), and 40,775 subjects had newly diagnosed severe chronic periodontitis (SCP). Two 1:1 propensity score matched cohorts were created with 8,624 patients each in the MCP and SCP groups. To analyze the risk of dementia, a Cox proportional-hazard model was used to calculate hazard ratios with 95% confidence intervals (CIs).
RESULTS In the Kaplan-Meier curve, the disease-free probability was significantly lower in the SCP group than in the MCP group (p for log-rank=0.001). In the multivariable-adjusted model, the HR for the occurrence of dementia in the SCP group compared to the MCP group was 1.15 (95% CI, 1.04 to 1.27; p=0.009). A subgroup analysis revealed a significant association between dementia and the severity of periodontitis, especially in subjects who were male, aged ≥70 years, and had comorbidities.
CONCLUSIONS Reducing the severity of chronic periodontitis can help to reduce the risk of dementia. Therefore, it is necessary to aggressively conduct early dementia-prevention programs for males under the age of 70 that include dental health to prevent the progression of periodontitis from mild to severe.
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Summary
Korean summary
본 연구는 만성치주질환을 가진 노인의 만성치주질환 중등도에 따른 치매 발생위험 차이를 분석하였다. 그 결과, 만성치주질환 중등도가 높은 그룹에서 만성치주질환 중등도가 낮은 그룹에 비해 치매 발생위험이 높았으며, 특히, 남성과 70세 이상 그룹에서 유의한 차이가 있었다. 따라서 70세 이하 남성 노인을 대상으로 만성치주질환이 진행되지 않도록 효과적인 구강관리가 필요할 것이다.
Key Message
In this study, we confirmed that the severity of chronic periodontitis is related to the risk of dementia, so efforts for effective oral care will be needed.
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Citations
Citations to this article as recorded by - With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease
James M. Noble, Panos N. Papapanou
Journal of Alzheimer's Disease.2023; 93(3): 991. CrossRef - Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration
David Visentin, Ivana Gobin, Željka Maglica
Microorganisms.2023; 11(7): 1832. CrossRef - Association between statin compliance and risk of dementia among patients with chronic periodontitis
Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
Oral Diseases.2023;[Epub] CrossRef
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