Published online Oct 7, 2020. doi: 10.3748/wjg.v26.i37.5661
Peer-review started: May 18, 2020
First decision: July 29, 2020
Revised: August 7, 2020
Accepted: September 16, 2020
Article in press: September 16, 2020
Published online: October 7, 2020
Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease (IBD) remains unclear.
To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis.
A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn’s disease (CD), ulcerative colitis (UC)] using the International Classification of Disease 10th revision and rare intractable disease codes, was compared between the periodontitis and non-periodontitis groups until 2017.
A total of 1092825 individuals (11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the non-periodontitis group (P < 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively (P < 0.01). Men were 604307 (55.3%) and 4844383 (54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval (CI): 1.008-1.182], but not CD (adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis.
Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.
Core Tip: We evaluate the impact of periodontitis on the development of ulcerative colitis (UC) using the nationwide population-based cohort data. In total, 9950548 individuals undergoing national health screenings in 2009 were included in this study and were followed for an average of 7.26 years. Patients with periodontitis had a higher risk of UC than those without periodontitis. Current smokers over 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers without periodontitis. Periodontitis was significantly associated with the risk of UC and cigarette smoking could superimpose the impact of periodontitis on UC, especially in elderly people.