以台灣全民健保資料庫分析慢性牙周炎的婦女患多囊卵巢綜合症候群的關聯性

多囊腫卵巢綜合症（Polycystic ovary syndrome，PCOS）是一種育齡婦女最常見且複雜的內分泌疾病之一。假設體內激素和發炎都會影響牙周組織。以前的研究結果表明PCOS患者得牙齦炎的患病率可能更高。然而，PCOS與慢性牙周炎（CP）之間的關係尚不清楚。在本研究中，我們在台灣進行的一項全國性人群回顧性世代研究中評估了慢性牙周炎暴露患者得PCOS的風險。我們研究了2001年至2012年台灣人口的就醫數據。從國家健康保險數據庫中確定了24,410名女性CP患者，年齡在50歲之前。選擇24,410個對照，隨機頻率匹配年齡，性別和指數年份的一般人群，並以年齡層分為四個類別來研究。通過Cox比例風險回歸模型分析PCOS的風險，包括性別，年齡和合併症。在這研究中，觀測到24,410名女性CP患者（平均年齡：35.14 ± 8.81歲）和24,410名對照者（平均年齡：35.14 ± 8.8歲）分別為8.89和8.85年。在CP隊列中共鑑定出441例患有PCOS，在非CP隊列中鑑定出304例。多變量Cox回歸分析顯示，CP群組中PCOS的發生率顯著高於非CP群組（校正風險比：1.44, 95％信賴區間：1.24-1.67）。總括來說，這項全國性的回顧性世代研究表明，在台灣女性CP患者的PCOS風險明顯高於無CP患者。

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Both hormonal and inflammatory influences are assumed to affect periodontal tissues. Previous studies have shown that PCOS patients could have higher prevalence of gingival inflammation. However, the relationship between PCOS and chronic periodontitis (CP) is not clear. We evaluated the risk of PCOS from CP exposure in a nationwide population-based retrospective cohort study in Taiwan. We studied the claims data of Taiwanese population from 2001 to 2012. The 24,410 female patients with CP were identified from the National Health Insurance Database. All of them were less than 50 years old. The 24,410 controls were selected with randomly frequency matched by age, sex, and index year from the general population. The population was divided into 4 categories in age for analysis. The risk of PCOS was analyzed by Cox proportional hazards regression models including sex, age, and comorbidities. In this study, 24,410 female patients with CP (mean age: 35.14 ± 8.81 years) and 24,410 controls (mean age: 35.14 ± 8.8 years) were observed for 8.89 and 8.85 years, respectively. A total of 441 cases of PCOS were identified in CP cohort and 304 cases in non-CP cohort. Multivariate Cox regression analysis indicated that the incidence rate of PCOS was significantly higher in CP cohort than those who in non-CP cohort (adjusted HR: 1.44, 95% CI: 1.24-1.67). As results, this nationwide retrospective cohort study demonstrated that the risk of PCOS was significantly higher in female patients with CP than those without CP in Taiwan.