- 學位論文
台灣地區慢性牙周病與肥胖風險之相關性研究
A risk analysis between obesity and chronic periodontitis in Taiwan
摘要
研究背景與目的：肥胖症患者所引起的系統性慢性發炎，可能增加罹患牙周疾病的風險，兩者之間的致病機轉皆與長期慢性發炎有關。本研究欲藉由全民健保資料庫，分析台灣地區兩者之間的相關性，並且探討相關風險因子所扮演的角色。研究方法：回顧分析台灣地區全民健保資料庫（National Health Insurance Research database，NHIRD）在2000年至2013年之間的數據，挑選一百萬個研究樣本，並針對肥胖與牙周病使用2010年百萬歸人檔進行世代研究。肥胖症世代以1:4比例條件配對後，利用傾向分數配對法再配對出1:2比例的對照世代，進行Cox比例風險模型分析，計算實驗世代與對照世代之間罹患慢性牙周病的風險。研究結果：本研究包括實驗世代（n = 4140）和對照世代（n = 8280），平均年齡分別為 41.7 ± 13.8 歲和 42.0 ± 14.0 歲。肥胖患者罹患慢性牙周病的風險是非肥胖患者的 1.12 倍（風險比，1.12；95%信賴區間，1.01-1.25），肥胖世代罹患慢性牙周病的累積發病率較高（p = 0.037）。在按年齡和性別進行的次組別分析中，年齡等於或大於 65 歲的組別中，罹患慢性牙周病的風險比為1.98（95%信賴區間，1.22-3.22），但男、女性別組別中，肥胖和非肥胖組罹患慢性牙周病的風險無差異。研究結論：台灣地區肥胖症和慢性牙周病是有顯著正相關，特別是年紀大於65歲的肥胖症族群罹患慢性牙周病的風險顯著增加。
並列摘要
Background and Objective: Previous studies have suggested that obesity might be associated with chronic periodontitis (CP); however, no clear conclusions have been reached so far. In this retrospective cohort study, we aimed to investigate the association between obesity and CP by using a large population-based dataset in Taiwan. Material and Methods: A population-based retrospective cohort study was conducted using the Longitudinal Health Insurance Database 2010 (LHID2010) derived from the National Health Insurance Research database in Taiwan, from 2000 to 2013. Obesity and non-obesity groups were matched with sex, age, urbanization level, socioeconomic status, and the related comorbidities by using the propensity score method at a 1:2 ratio. Results: An obese cohort (n = 4140) and a non-obese cohort (n = 8280) were included in this study, with an average age of 41.7 ± 13.8 years and 42.0 ± 14.0 years, respectively. The risk of CP for the patients with obesity was 1.12-fold compared with those without obesity (hazard ratio, 1.12; 95% confidence interval, 1.01–1.25). In the subgroup analysis according to age and sex, the hazard ratio of CP were 1.98 (95% confidence interval, 1.22–3.22) in the subgroup of age equal to or older than 65 years. The risk of CP showed no difference between obesity and non-obesity groups in both sex. Conclusions: This population-based cohort study demonstrated that obesity was associated with the development of CP in Taiwan.