Kuei-Chen Lee1,2, Yung-Tsan Wu2, Wu-Chien Chien3,4,5, Chi-Hsiang Chung6,7, Chih-Hao Shen8, Liang-Cheng Chen2, Yi-Shing Shieh9,10. 1. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan. 2. Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 3. School of Public Health, National Defense Medical Center, Taipei, Taiwan. chienwu@ndmctsgh.edu.tw. 4. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan. chienwu@ndmctsgh.edu.tw. 5. Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan. chienwu@ndmctsgh.edu.tw. 6. School of Public Health, National Defense Medical Center, Taipei, Taiwan. 7. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan. 8. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 9. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan. ndmcyss@mail.ndmctsgh.edu.tw. 10. Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, 114 No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei, Taiwan. ndmcyss@mail.ndmctsgh.edu.tw.
Abstract
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. The coexistence of COPD and temporomandibular disorder (TMD) has been noted, and dysfunctional mastication resulting from TMD can worsen individuals' nutritional status. This association between COPD and TMD has been rarely discussed in previous studies. Therefore, this study aimed to determine whether osteoporosis increases the risk of TMD in COPD and whether anti-osteoporosis medications can prevent TMD. MATERIALS AND METHODS: This retrospective nationwide population-based study utilized the Taiwan National Health Insurance Research Database. We enrolled 52,652 COPD patients between 2000 and 2015: 13,163 with osteoporosis and 39,489 without osteoporosis. Groups of COPD patients with and without osteoporosis were age- and sex-matched. A multivariable Cox proportional hazards regression model was used to evaluate the risk of TMD development in COPD patients with and without osteoporosis over 15 years. RESULTS: There was a higher risk of TMD occurrence in COPD patients with osteoporosis than in those without osteoporosis (adjusted hazard ratio 2.564, P < 0.001) after adjusting for demographic variables and associative comorbidities. Osteoporosis, hypertension, vertebral compression fracture, and nonpsychotic mental disorders were risk factors contributing to TMD development in patients with COPD. Anti-osteoporosis medications were associated with the prevention of TMD development concomitant with osteoporosis and COPD (adjusted hazard ratio 0.617, P = 0.004). CONCLUSIONS: Patients with COPD and osteoporosis are at a higher risk of developing TMD, and anti-osteoporosis medications can prevent the development of TMD in this context.
INTRODUCTION:Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. The coexistence of COPD and temporomandibular disorder (TMD) has been noted, and dysfunctional mastication resulting from TMD can worsen individuals' nutritional status. This association between COPD and TMD has been rarely discussed in previous studies. Therefore, this study aimed to determine whether osteoporosis increases the risk of TMD in COPD and whether anti-osteoporosis medications can prevent TMD. MATERIALS AND METHODS: This retrospective nationwide population-based study utilized the Taiwan National Health Insurance Research Database. We enrolled 52,652 COPDpatients between 2000 and 2015: 13,163 with osteoporosis and 39,489 without osteoporosis. Groups of COPDpatients with and without osteoporosis were age- and sex-matched. A multivariable Cox proportional hazards regression model was used to evaluate the risk of TMD development in COPDpatients with and without osteoporosis over 15 years. RESULTS: There was a higher risk of TMD occurrence in COPDpatients with osteoporosis than in those without osteoporosis (adjusted hazard ratio 2.564, P < 0.001) after adjusting for demographic variables and associative comorbidities. Osteoporosis, hypertension, vertebral compression fracture, and nonpsychotic mental disorders were risk factors contributing to TMD development in patients with COPD. Anti-osteoporosis medications were associated with the prevention of TMD development concomitant with osteoporosis and COPD (adjusted hazard ratio 0.617, P = 0.004). CONCLUSIONS:Patients with COPD and osteoporosis are at a higher risk of developing TMD, and anti-osteoporosis medications can prevent the development of TMD in this context.
Entities:
Keywords:
Chronic obstructive pulmonary disease; National health insurance research database; Osteoporosis; Retrospective studies; Temporomandibular disorder
Authors: Ramsey Sabit; Charlotte E Bolton; Peter H Edwards; Rebecca J Pettit; William D Evans; Carmel M McEniery; Ian B Wilkinson; John R Cockcroft; Dennis J Shale Journal: Am J Respir Crit Care Med Date: 2007-03-15 Impact factor: 21.405