多囊性卵巢疾病患者應該諮詢和篩檢有無潛在的代謝疾病和產科併發症。然而，關於多囊性卵巢症候群(PCOS)患者會不會增加罹患牙周病的風險仍然存在爭議。因此我們進一步研究多囊性卵巢症候群(PCOS)與牙周病之間的關係。 研究目的：評估多囊性多囊卵巢症候群(PCOS)與牙周病的相關性。 研究方法：本次運用回溯性世代研究(retrospective cohort study)，使用採用2000~2013年的台灣全民健保研究資料庫數據(Longitudinal Health Insurance Database 2000)。本回溯性世代研究(retrospective cohort study)，是依照居民城市化比例去統計12~50歲的多囊性卵巢患者罹患牙周病的比例。以卡方檢驗法(Chi-square)比較多囊與非多囊患者之間不同疾病的名義變項，再用Kaplan-Meier plot與log-rank-test計算多囊患者的牙周病累積發生率，而PCOS與牙周病的相關性，是採用多變量分析和多重Cox回歸評估來計算校正後共病風險比(aHR)的95%信賴區間值。使用SAS 9.4軟體分析所有資料，而p值小於0.05在統計學上被認為是有顯著關係的。 結論與建議：本研究發現PCOS與牙周病有關。PCOS患者與非PCOS患者的牙周病的發病率比值(IRR)為1.22 (95%的信賴區間值是1.14~1.31，P值小於0.0001)。另外，多囊患者與非多囊患者相比需要進階治療牙周病的比例為1.17 (95%的信賴區間值為1.00~1.37，P值=0.0469) Introduction: Patients with polycystic ovary disease should be counseled and screened for potential metabolic disease and obstetric complications. However, it remains controversial as to whether PCOS increases the risk of developing periodontal disease. Therefore, we investigated the relationship between PCOS and periodontal disease. Objective: To evaluate the relationship between polycystic ovary disease and periodontal disease.
Materials and methods: This retrospective cohort study analyzed long-term data from the Longitudinal Health Insurance Database 2000 in Taiwan. We identified patients with PCOS from 2000 and 2013, and matched them by age and urbanization with individuals without PCOS. Chi-square test was used to compare differences in nominal variables between the PCOS and comparator groups. Kaplan-Meier plot and log-rank test were conducted to determine the cumulative incidence of periodontal disease. Associations with PCOS and periodontal disease were evaluated by multiple Cox regression to calculate the adjusted hazard ratio (aHR) and 95% Confidence Interval (95% C.I.). Data were analyzed using SAS 9.4 software and a p value of less than 0.05 was considered statistically significant.
Results and Conclusion: We found PCOS was associated with periodontal disease. Compared with non-PCOS patients, the incidence rate ratio (IRR) of periodontal disease in PCOS patients was 1.22 (95% C.I.:1.14-1.31, P<.0001). Moreover, the IRR of intensive treatment for periodontal disease was 1.17 (95% C.I.:1.00-1.37, p=0.0469) in patients with PCOS. After adjusting for confounders, the multiple Cox regression model revealed higher risks of periodontal disease (aHR=1.20 with 95% C.I.: 1.11-1.28, p<0.0001) and intensive treatment for periodontal disease (aHR=1.07 with 95% C.I.: 1.06-1.08, p<0.0001) in the PCOS group compared with those of the control group.
