Identifying Mechanisms Underlying the Association Between Cardiovascular Diseases and Periodontitis Using in Silico Analysis of Canonical Pathways

Sheng‐Kai, Kevin; Chiang, Cheng‐Yang; Lopez, Angel Alfonso Velarde; Wang, Li‐Tzu; Tsai, Shin‐Yi

doi:10.1016/j.ahj.2020.10.038

Cited by 7 publications

(5 citation statements)

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“…However, because previous studies did not specifically elaborate on the long‐term effect of tonsillectomy over an extended period of follow up in all age subgroups, 32 in our study we included subgroups from all ages over an observational period of 12 years. Consequently, our findings illustrated that the removal of tonsils was followed by a significantly high risk of periodontitis, for which dysbiosis in the digestive system, including aggressive and acute periodontitis in the oral cavity 33–35 and IBS in the gut, 9 are well‐known complications in immunocompromised patients that underwent major surgeries.…”

Section: Discussionmentioning

confidence: 74%

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

Sheng‐Kai

Thota

et al. 2022

Journal of Periodontology

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Background To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis. Methods Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population‐based cohort study consisting of cases of newly‐onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. A total of 1482 tonsillectomy cases and 14,796 non‐tonsillectomy controls were selected. Propensity score matching37 between the tonsillectomy group and the non‐tonsillectomy group was conducted to exclude the confounding effect resulting from indications of tonsillectomy. Cox proportional hazard model and subgroup analyses were conducted to identify subpopulations at risk of tonsillectomy‐associated periodontitis, and a sub‐outcome analysis was applied to identify the subtype of tonsillectomy‐associated periodontitis. Results A total of 648 patients who had undergone tonsillectomy and 648 out of 6509 propensity score‐matched controls were retrieved, among which 230 cases in the tonsillectomy group were associated with post‐surgical periodontitis (adjusted HR = 1.31, 95% CI = 1.08 to 1.59). The association persisted in a subpopulation of patients with periodontitis who received mechanical and surgical treatments for periodontitis (adjusted HR = 1.33, 95% CI = 1.09 to 1.63). The incidence of periodontitis was significantly high in the individuals who underwent tonsillectomy and was particularly high in those that were below 12 years of age (HR = 1.58, 95% CI = 1.10 to 2.27). The risk of periodontitis increased 4 years after tonsillectomy (HR = 1.82; 95% CI = 1.29 to 2.59). The majority of post‐tonsillectomy periodontitis was aggressive and acute periodontitis (HR = 1.37; 95% CI = 1.10 to 1.71). Conclusions Tonsillectomy performed in pediatric patients of < 12 years old, increased the risk of developing periodontitis. Aggressive and acute periodontitis as a long‐term, postoperative adverse event took place at 4 years or longer after tonsillectomy.

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Section: Discussionmentioning

confidence: 74%

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

Sheng‐Kai

Thota

et al. 2022

Journal of Periodontology

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“…Propensity score matching ( 18 – 25 ) was used to homogenize the baseline characteristics of the two groups ( 26 – 35 ). To reveal the potential risk factors contributing to the pathogenesis of pSS during follow-up, we performed multiple Cox regression on selected comorbidities to estimate the adjusted hazard ratios (aHRs) of pSS and calculated the corresponding 95% confidence intervals (CIs) to ensure the precision and accuracy of the analysis.…”

Section: Methodsmentioning

confidence: 99%

Risk of primary Sjogren’s Syndrome following human papillomavirus infections: a nationwide population-based cohort study

Chen

Dong

Chang³

et al. 2022

Front. Immunol.

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IntroductionViral infection is an exogeneous factor for primary Sjogren’s syndrome (pSS). This study investigated the association between human papillomavirus (HPV) infections and pSS through a nationwide population based cohort study.MethodsPatients with HPV infections between January, 1999 and December, 2013 were included. The incidence of new-onset pSS in patients with HPV infections and non-HPV controls were derived. The multiple Cox regression model derived the risk of pSS in patients with HPV infections. Subgroup analysis and sensitivity analysis were performed to validate the association.ResultsDuring a follow-up period of 12 years, the adjusted hazard ratio (aHR) of pSS in patients with HPV infections was significantly higher than that in non-HPV controls (aHR=1.64, 95% CI=1.47-1.83, P<0.001). The risk of pSS increased with age and the risk increased by 2.64-fold (95% CI= 2.37-2.93) for those older than 45 years. The significant association between HPV infections and the risk of pSS persisted in the sensitivity analysis restricted in HPV infections that lasted over 12 months (aHR=1.63, 95%CI=1.45-1.83, P<0.0001). Subgroup analyses revealed that both male (aHR=1.83, 95%CI=1.47-2.28, P<0.0001) and female (aHR=1.58, 95%CI=1.40-1.79, P<0.0001) patients with HPV infections and HPV-infected patients aged between 16 and 45 years (aHR=1.60, 95%CI=1.34-1.91, P<0.0001) and over 45 years (aHR=1.67, 95%CI=1.46-1.91, P<0.0001) were associated with a significantly greater risk of pSS.ConclusionPatients with HPV infections presented with a significantly higher risk of pSS, regardless of age and sex.

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“…In this first hypothesis, instead of obvious infection and inflammation that develops into septic arthritis (42), periodontal pathogens may cause or aggravate the inflammatory process in the joints, finally developing into osteoarthritis, or even severe osteoarthritis that requires surgical treatment. Apart from being involved in idiopathic or primary osteoarthritis, periodontitis and periodontopathic bacterial invasion (43) have been shown to increase the risk of RA (7,11,17) and DM (5,10,14,18,20,44,45). These clinically evident correlations provide a plausible causal interpretation that may connect periodontitis to secondary osteoarthritis.…”

Section: Discussionmentioning

confidence: 98%

“…Apart from being involved in idiopathic or primary osteoarthritis, periodontitis and periodontopathic bacterial invasion ( 43 ) have been shown to increase the risk of RA ( 7 , 11 , 17 ) and DM ( 5 , 10 , 14 , 18 , 20 , 44 , 45 ). These clinically evident correlations provide a plausible causal interpretation that may connect periodontitis to secondary osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

Bidirectional Relationship Between Osteoarthritis and Periodontitis: A Population-Based Cohort Study Over a 15-year Follow-Up

et al. 2022

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ObjectiveTo identify the relationship between osteoarthritis and periodontitis.Methods144,788 periodontitis patients and 144,788 propensity score-matched controls without history of periodontitis were enrolled in this cohort study. A Cox proportional hazard model was used to estimate the risk of osteoarthritis. Survival analysis was utilized to assess the time-dependent effect of periodontitis on osteoarthritis. Age and gender were stratified to identify subgroups at risk. A symmetrical case-control analysis was designed to determine the relationship between present periodontitis and history of osteoarthritis.ResultsPatients with periodontitis had higher risk of osteoarthritis (hazard ratio, HR =1.15, 95% CI =1.12–1.17, p < 0.001) and severe osteoarthritis that led to total knee replacement or total hip replacement (TKR/THR) (HR =1.12, 95% CI =1.03–1.21, p < 0.01) than controls, which was time-dependent (log-rank test p < 0.01). The effect of periodontitis on osteoarthritis was significant in both genders and age subgroups over 30 years-old (all p < 0.001). Among them, females (HR=1.27, 95% CI = 1.13–1.42, p < 0.001) and patients aged over 51 (HR= 1.21, 95% CI =1.10-1.33, p < 0.001) with periodontitis were predisposed to severe osteoarthritis. In addition, periodontitis patients were more likely to have a history of osteoarthritis (odds ratio = 1.11, 95% CI = 1.06 - 1.17, p < 0.001).ConclusionsThese findings suggest an association between periodontitis and a higher risk of osteoarthritis, including severe osteoarthritis that led to TKR/THR. Likewise, periodontitis is more likely to develop following osteoarthritis. A bidirectional relationship between osteoarthritis and periodontitis was observed.

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Identifying Mechanisms Underlying the Association Between Cardiovascular Diseases and Periodontitis Using in Silico Analysis of Canonical Pathways

Cited by 7 publications

References 0 publications

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

Risk of primary Sjogren’s Syndrome following human papillomavirus infections: a nationwide population-based cohort study

Bidirectional Relationship Between Osteoarthritis and Periodontitis: A Population-Based Cohort Study Over a 15-year Follow-Up

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