Abstract
Possible links between periodontitis and various cardiometabolic and autoimmune diseases have been advocated on the basis of chronic inflammation or oxidative stress. However, the association between periodontitis and thyroid dysfunction is under-researched. Participants without previous thyroid disease or ongoing thyroid-related medication were included from a nationwide population-level survey. Participants were categorized into tertiles of thyroid stimulating hormone (TSH) levels (first tertile < 1.76 mIU/L; second tertile 1.76–2.83 mIU/L; third tertile > 2.83 mIU/L), and periodontal condition was assessed using the Community Periodontal Index. Of the total of 5468 participants, 1423 had periodontitis (26%). A significant difference in the weighted prevalence of periodontitis according to TSH tertiles was observed, with the highest prevalence in the first tertile (26.5%) and the lowest prevalence in the third tertile (20.9%, p = 0.003). Subjects in the first TSH tertile had higher odds for periodontitis than those in the third tertile (OR 1.36, 95% CI 1.10–1.68; p for trend = 0.005) after adjusting for covariates. This association was consistent across subgroups and within sensitivity analyses among subjects without specific factors affecting thyroid function or diseases reported to be related to periodontitis. The present study demonstrated that low TSH levels were associated with significantly higher odds for periodontitis.
Highlights
Possible links between periodontitis and various cardiometabolic and autoimmune diseases have been advocated on the basis of chronic inflammation or oxidative stress
From a total of 6255 participants, representative of 13,033,409 Koreans, a final sample of 5468 subjects with data on thyroid function status and Community Periodontal Index (CPI) scores were eligible for analyses (Fig. 1)
Table 4), 1.25 (1.01–1.55) in participants without coronary artery disease (Supplementary Table 5), 1.25 (1.01– 1.55) in participants without rheumatoid arthritis (Supplementary Table 6), and 1.35 (1.09–1.66) in participants without rheumatoid arthritis (Supplementary Table 7) when comparing participants in the first thyroid stimulating hormone (TSH) tertile to those in the third tertile. This nationwide cohort study of 5468 participants showed that thyroid function was significantly associated with periodontitis
Summary
Possible links between periodontitis and various cardiometabolic and autoimmune diseases have been advocated on the basis of chronic inflammation or oxidative stress. Subjects in the first TSH tertile had higher odds for periodontitis than those in the third tertile (OR 1.36, 95% CI 1.10–1.68; p for trend = 0.005) after adjusting for covariates This association was consistent across subgroups and within sensitivity analyses among subjects without specific factors affecting thyroid function or diseases reported to be related to periodontitis. Periodontitis is one of the most common chronic infectious diseases in humans, occurring as a result of dysregulation of the host immune response triggered by subgingival microorganisms[4,5] It is highly prevalent worldwide with severe periodontitis affecting 7.4% of the global population, posing a significant economic burden and major public health c hallenge[6,7]. This study aimed to evaluate the link between periodontitis and thyroid function using data from Korea National Health and Nutrition Examination Survey (KNHANES), which is a large population-level survey performed by Korean government that provides latest nationally representative data containing credible health data carried out by well-trained staffs[30]
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