Kevin Sheng-Kai Ma1,2,3, Jung-Nien Lai4,5, John Jims Veeravalli3, Lu-Ting Chiu6,7, Thomas E Van Dyke8,9, James Cheng-Chung Wei10,11,12. 1. Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 2. Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan. 3. Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan. 4. School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 5. Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan. 6. Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan. 7. College of Medicine, China Medical University, Taichung, Taiwan. 8. Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts, USA. 9. Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA. 10. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. 11. Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan. 12. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: To determine the bidirectional link between periodontitis and fibromyalgia. METHODS: In this cohort study, 196,428 periodontitis patients and 196,428 propensity score-matched non-periodontitis controls were enrolled. A Cox proportional hazard model was utilized to estimate the risk of fibromyalgia and survival analysis was adopted to assess the time-dependent effect of periodontitis on fibromyalgia. Subgroup analyses stratified by age, sex, and tracking period were conducted to identify susceptible populations. A parallel and symmetrical cohort that recruited 141,439 fibromyalgia patients and 141,439 propensity score-matched non-fibromyalgia controls ascertained the inverse effect of fibromyalgia on incident periodontitis. RESULTS: Patients with periodontitis were more likely to develop fibromyalgia than non-periodontitis controls (HR = 1.42, 95% CI = 1.39-1.44, P < 0.001), which persisted in the survival analysis (log-rank test P < 0.0001). This effect was significant in both sexes and all age subgroups, and was particularly evident in males (HR = 1.52, 95% CI = 1.48-1.56, P < 0.001) and younger periodontitis patients (HR = 1.55, 95% CI = 1.50-1.60, P < 0.001). Fibromyalgia patients who never had periodontitis presented with greater risk for periodontitis over time (HR = 1.43, 95% CI = 1.40 - 1.45, P < 0.001; log-rank test P < 0.0001). CONCLUSIONS: Patients of both sexes and all age subgroups with periodontitis presented with a greater risk of fibromyalgia. Subgroups that were the most susceptible to periodontitis-associated fibromyalgia were periodontitis patients that were males and below 30 years old. Risks of periodontitis were also greater in fibromyalgia patients who never had periodontitis.
BACKGROUND: To determine the bidirectional link between periodontitis and fibromyalgia. METHODS: In this cohort study, 196,428 periodontitis patients and 196,428 propensity score-matched non-periodontitis controls were enrolled. A Cox proportional hazard model was utilized to estimate the risk of fibromyalgia and survival analysis was adopted to assess the time-dependent effect of periodontitis on fibromyalgia. Subgroup analyses stratified by age, sex, and tracking period were conducted to identify susceptible populations. A parallel and symmetrical cohort that recruited 141,439 fibromyalgia patients and 141,439 propensity score-matched non-fibromyalgia controls ascertained the inverse effect of fibromyalgia on incident periodontitis. RESULTS: Patients with periodontitis were more likely to develop fibromyalgia than non-periodontitis controls (HR = 1.42, 95% CI = 1.39-1.44, P < 0.001), which persisted in the survival analysis (log-rank test P < 0.0001). This effect was significant in both sexes and all age subgroups, and was particularly evident in males (HR = 1.52, 95% CI = 1.48-1.56, P < 0.001) and younger periodontitis patients (HR = 1.55, 95% CI = 1.50-1.60, P < 0.001). Fibromyalgia patients who never had periodontitis presented with greater risk for periodontitis over time (HR = 1.43, 95% CI = 1.40 - 1.45, P < 0.001; log-rank test P < 0.0001). CONCLUSIONS: Patients of both sexes and all age subgroups with periodontitis presented with a greater risk of fibromyalgia. Subgroups that were the most susceptible to periodontitis-associated fibromyalgia were periodontitis patients that were males and below 30 years old. Risks of periodontitis were also greater in fibromyalgia patients who never had periodontitis.
Authors: K S Ma; H Hasturk; I Carreras; A Dedeoglu; J J Veeravalli; J Y Huang; A Kantarci; J C Wei Journal: J Dent Res Date: 2021-10-13 Impact factor: 6.116
Authors: Kevin Sheng-Kai Ma; Chee-Ming Lee; Po-Hung Chen; Yan Yang; Yi Wei Dong; Yu-Hsun Wang; James Cheng-Chung Wei; Wen Jie Zheng Journal: Front Med (Lausanne) Date: 2022-06-13
Authors: Kevin Sheng-Kai Ma; Jung-Nien Lai; Eshwar Thota; Hei-Tung Yip; Ning-Chien Chin; James Cheng-Chung Wei; Thomas E Van Dyke Journal: Front Immunol Date: 2022-07-25 Impact factor: 8.786