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. 2022 Jul 25:13:909783.
doi: 10.3389/fimmu.2022.909783. eCollection 2022.

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

Kevin Sheng-Kai Ma  1   2   3 , Jung-Nien Lai  4   5 , Eshwar Thota  3 , Hei-Tung Yip  6   7 , Ning-Chien Chin  8   9 , James Cheng-Chung Wei  10   11   12 , Thomas E Van Dyke  13   14
Affiliations

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

Kevin Sheng-Kai Ma et al. Front Immunol. .

Abstract

Objective: To identify the relationship between osteoarthritis and periodontitis.

Methods: 144,788 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.

Results: Patients 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).

Conclusions: These 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.

Keywords: cohort study; inflammation; osteoarthritis; periodontitis; total hip replacement; total knee replacement.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient selection flowchart for the periodontitis cohort.
Figure 2
Figure 2
Cumulative incidence of osteoarthritis in patients with and without periodontitis.
See this image and copyright information in PMC

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