| Abstract: | 隨著台灣人口快速老化，帕金森氏症的盛行率也不斷增加。此外，在老年族群中，牙周發炎疾病常造成牙齒喪失且隨著年齡而增加其盛行率。在先前的研究中指出牙周發炎疾病可能被認為是帕金森氏症神經病變的促成因素之一。然而，牙周發炎疾病與帕金森氏症之間的相關性仍然不確定。因此，本研究分析牙周發炎疾病和帕金森氏症之間的風險關聯。研究中運用台灣全民健康保險研究資料庫進行回溯性配對世代型研究。從1997年至2004年期間新診斷為牙周發炎疾病，共有5,396例患者。根據性別、年齡、新診斷年份和合併症，共有10,792例沒有牙周發炎疾病患者來進行配對。進行Cox風險回歸分析以評估罹患帕金森氏症風險。在最後追蹤中，牙周發炎疾病暴露組有176名為3.26％以及未暴露組有275名為2.55％的患者分別發展為帕金森氏症。患有牙周發炎疾病而發生帕金森氏症風險較高（調整後風險比= 1.431, 95％信賴區間=1.141-1.794, p = 0.002），研究結果顯示牙周發炎疾病會增加帕金森氏症發展之相關性風險。進一步使用台灣全民健康保險研究資料庫進行回溯性之巢式病例對照研究，以及分析牙結石清除與帕金森氏症發展之間的相關性。運用配對性別、年齡及新診斷年份（帕金森氏症發生年份）分析從2005至2013年期間新診斷的帕金森氏症患者4,765例和無帕金森氏症患者19,060例。在校對共病症和城市化水平進行調整後，使用條件式邏輯迴歸來估計罹患帕金森氏症風險。在第1組次群體，牙結石清除對於年齡在40至69歲的個體群中，在沒有牙周發炎疾病的患者顯示出，對於帕金森氏症的發展有保護作用，特別是對於連續5年皆有進行牙結石清除（調整後勝算比= 0.204, 95％信賴區間= 0.047-0.886, p = 0.0399）。整體來說，無論是否連續5年進行牙結石清除，牙結石清除的保護作用對於牙周發炎疾病患者及無牙周發炎疾病患者都有益處。總結發現牙周發炎疾病與罹患帕金森氏症之風險有正相關，且牙結石清除有助於降低罹患帕金森氏症以達預防之效果。
The prevalence of Parkinson’s disease (PD) increased as the population in Taiwan aged rapidly recently. In addition, periodontal inflammatory disease (PID) accounts for most cases of tooth loss, and their impact increases with age. The prevalence of PID is more common in older age groups. In previous studies, PID can be suggested as one of the contributing factors for neurodegeneration of PD. However, the exact relationship between PID and PD is unclear. Therefore, the purpose of this study was to investigate the association between PID and PD. We conducted a retrospective matched-cohort study by using the Taiwanese National Health Insurance Research Database. We identified 5,396 patients with newly diagnosed PID during 1997–2004 and 10,792 cases without PID by matching sex, age, index of the year (occurrence of PID), and comorbidity. Cox proportional hazard regression was used to evaluate the risk of subsequent PD. At the final follow-up, a total of 176 (3.26%) and 275 (2.55%) individuals developed PD in the case and control groups, respectively. Patients with PID have a higher risk of developing PD (adjusted hazard ratio = 1.431, 95%CI =1.141–1.794, p = 0.002). These results show that PID is associated with an increased risk of developing PD. Second, a retrospective nested case-control study was performed using the National Health Insurance Research Database and to analyze the association between dental scaling and development of PD. The authors identified 4,765 patients with newly diagnosed PD from 2005 to 2013 and 19,060 individuals without PD by matching sex, age, and index of the year (occurrence of PD). Conditional logistic regression was used to estimate the risk of PD after adjustment for comorbidities and urbanization level. In subgroup 1, with individuals aged 40-69 years, individuals without PID showed a protective effect of dental scaling against PD development, especially for dental scaling over 5 consecutive years (adjusted odds ratio = 0.204, 95%CI = 0.047-0.886, p = 0.0399). In general, the protective effect of dental scaling showed the benefit for individuals with PID and for those without PID, regardless of whether dental scaling was performed for 5 consecutive years. In conclusion, the results show that PID is associated with an increased risk of developing PD. In addition, dental scaling reduces PID may decrease the risk of developing PD. |
