Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis.
Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis.
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DOI：
10.3389/fimmu.2016.00080
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发表时间：
2016
影响因子：
7.3
通讯作者：
Sofat N
中科院分区：
文献类型：
--
作者：
Fuggle NR;Smith TO;Kaul A;Sofat N
风湿性关节炎（RA）和牙周炎都是慢性炎症性疾病，在发病机制、组织病理学和人口统计学方面表现出相似性。这些条件之间的关联以前已被证明，但最近受到质疑。使用与RA和牙周炎相关的检索词检索已发表的数据库，如MEDLINE、EMBASE和PsycINFO。如果文章包括诊断为牙周炎（或牙周疾病参数）的RA患者人数与对照组相比的数据，则选择这些文章。排除了综述文章、病例报告、动物模型研究、非英语语言和摘要不可用的文章。提取数据，使用唐斯和布莱克工具进行批判性评价，并进行随机效应Mantel-Haenszel荟萃分析。21篇论文符合入选标准，并为荟萃分析提供了数据; 17项研究（共包括153，492例受试者）比较了RA与健康对照，4项研究（共包括1378例受试者）比较了RA与骨关节炎（OA）。与健康对照组相比，RA患者患牙周炎的风险显著增加（相对风险：1.13; 95%CI：1.04，1.23; p = 0.006; N = 153，277），RA患者的平均探诊深度、探诊出血风险（BOP）和临床附着丧失的绝对值显著增加。当比较RA和OA时，牙周炎的患病率没有显著差异;然而，OA中BOP的风险大于RA。RA和牙周炎之间的显着关联是由我们的系统回顾和荟萃分析的研究比较RA健康对照组的结果支持。然而，在我们的荟萃分析中，当比较RA和OA对照时，这并没有被复制。
Rheumatoid arthritis (RA) and periodontitis are both chronic inflammatory diseases, which demonstrate similarities in terms of mechanism, histopathology, and demography. An association between these conditions has been demonstrated previously but has been called into question more recently. The published databases, such as MEDLINE, EMBASE, and PsycINFO, were searched using search terms related to RA and periodontitis. Articles were selected if they included data on the number of people with RA diagnosed with periodontitis (or periodontal disease parameters) compared to a control comparison group. Review articles, case reports, animal model studies, non-English language, and articles with unavailable abstracts were excluded. Data were extracted, critically appraised using the Downs and Black tool, and a random-effect Mantel–Haenszel meta-analysis was performed. Twenty-one papers met the eligibility criteria and provided data for the meta-analysis; 17 studies (including a total of 153,492 participants) comparing RA to healthy controls and 4 (including a total of 1378 participants) comparing RA to osteoarthritis (OA). There was a significantly increased risk of periodontitis in people with RA compared to healthy controls (relative risk: 1.13; 95% CI: 1.04, 1.23; p = 0.006; N = 153,277) with a significantly raised mean probing depth, risk of bleeding on probing (BOP), and absolute value of clinical attachment loss in those with RA. When comparing RA and OA, there was no significant difference in the prevalence of periodontitis; however, the risk of BOP was greater in OA than RA. A significant association between RA and periodontitis is supported by the results of our systematic review and meta-analysis of studies comparing RA to healthy controls. In our meta-analysis, however, this is not replicated when comparing RA to OA controls.