Brit J Dermatol：慢性牙周炎增加病人患上牛皮癣的风险

根据于2012年7月3日在线发表在British Journal of Dermatology期刊上的一篇论文，患上慢性牙周炎(chronic periodontitis, CP)的病人被诊断患有牛皮癣(psoriasis)的几率增加了1.5倍。

来自中国台湾台北医学大学的Joseph J. Keller博士和 Herng-Ching Lin博士开展一项为期5年的群体研究来评估病人患上慢性牙周炎之后患上牛皮藓的风险。这项研究涉及115365名患有慢性牙周炎的病人和115365名未患上慢性牙周炎的病人。

研究人员发现，在这项为期5年的研究中，就患上慢性牙周炎和未患上慢性牙周炎的人们而言，每1000人的牛皮癣发病率分别是1.88和1.22。在追踪研究研究期间，在考虑死亡、月收入、地理差别和区域差别等因素之后，研究人员发现，相比于未患上慢性牙周炎的病人而言，患有慢性牙周炎的病人被诊断为患上牛皮癣的几率增加了1.5倍。牙龈切除术(gingivectomy)或牙周翻瓣术(periodontal flap operation)能够降低患上牛皮癣的风险，但是不能完全消除。

论文作者们在文中写道，“这项研究发现遭受慢性牙周炎折磨的病人患上牛皮癣的风险增加了，因而也能够将大规模群体研究的整合到这项开创性研究中。”

本文编译自Chronic periodontitis increases risk of psoriasis

doi: 10.1111/j.1365-2133.2012.11126.x
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The Effects of Chronic Periodontitis and Its Treatment on the Subsequent Risk of Psoriasis

J.J. Keller1, H.-C. Lin

Abstract Background:  Although psoriasis and chronic periodontitis (CP) may share an underlying immune dysregulation as part of their pathologies, only one small-scaled cross-sectional pilot study has investigated the potential association between CP and psoriasis to date. Objective:  This study aimed to investigate the subsequent risk for psoriasis following a diagnosis with CP by utilizing a cohort study design and population-based dataset in Taiwan. Methods:  In total, 115,365 patients with CP were included in the study cohort and 115,365 patients without CP were included in the comparison cohort. We individually tracked each patient for a five-year period to identify those who had subsequently received a diagnosis of psoriasis. A Cox proportional hazards regression was performed to compute the five-year risk of subsequent psoriasis following a diagnosis of CP. Results:  We found that the incidence rate of psoriasis during the five-year follow-up period was 1.88 (95% CI=1.77-1.99) per 1,000 person-years in patients with CP and 1.22 (95% CI=1.14-1.32) per 1,000 person-years in comparison patients. After censoring those who died during the follow-up period, and adjusting for monthly income and geographic region, compared with comparison patients, the HR of psoriasis for patients with CP was 1.52 (95% CI=1.38-1.70). Furthermore, the study subjects who had undergone a gingivectomy or periodontal flap operation only had a slightly higher adjusted risk of psoriasis than comparison patients (HR=1.26). Conclusions:  This study detected an increased risk for psoriasis among patients suffering from CP. Treatment for CP attenuated, but did not nullify, the risk for subsequent psoriasis.