A comparison of DALYs for periodontal disease in China between 1990 and 2013: insights from the 2013 global burden of disease study

Epidemiological and sociodemographic transitions of severe periodontitis incidence, prevalence, and disability-adjusted life years for 21 world regions and globally from 1990 to 2019: An age-period-cohort analysis

BACKGROUND

Severe periodontitis is one of the most prevalent diseases and a global public health problem due to its high incidence and prevalence. However, there are few studies on the burden of periodontitis in different regions of the world.

METHODS

We extracted data on the incidence, prevalence, and disability-adjusted life years (DALYs) from the Global Burden of Disease study as severe periodontitis burden measures. We also explored the global burden of severe periodontitis according to 21 world regions and Socio-Demographic Index (SDI) quintiles. The joinpoint model was used to analyze temporal trends of major regions from 1990 to 2019, and the age-period-cohort model was used to estimate age, period, and cohort trends in severe periodontitis.

RESULTS

Globally, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and disability-adjusted life years (DALYs) rate increased from 1990 to 2019 (percentage change: 5.77%, 7.78%, and 8.01%, respectively), with average annual percent changes of 0.2%, 0.3%, and 0.3%, respectively. The region with the highest DALY rate was western sub-Saharan Africa with a value of 142.5 (95% uncertainty interval: 56.3, 303.7) per 100,000 in 2019. For the ASIR, ASPR, and DALY, the age effect of severe periodontitis showed an increase followed by a decrease, the period effect showed an upward trend, the cohort effect showed an overall decreasing trend, and the cohort relative risk for incidence for some SDI quintiles showed a slight increase in recent years.

CONCLUSIONS

Oral health varies significantly across regions, and it is essential to address inequalities in oral health between countries. Effective measures to prevent severe periodontitis risk factors should also be taken in regions with low SDI.

Secular trends in severe periodontitis incidence, prevalence and disability-adjusted life years in five Asian countries: A comparative study from 1990 to 2017

AIMS

To investigate secular trends in severe periodontitis incidence, prevalence and disability-adjusted life year (DALY) rates in China, India, Japan, South Korea and Thailand from 1990 to 2017.

MATERIALS AND METHODS

Data were obtained from the "Global Burden of Disease Study" 2017. The annual percentage change and average annual percentage change were calculated using Joinpoint regression analysis. The independent age, period and cohort effects were estimated by age-period-cohort analysis.

RESULTS

From 1990 to 2017, the overall age-standardized incidence, prevalence and DALY rates increased in China, Japan and India, while decreasing in South Korea and Thailand. The highest incidence, prevalence and DALY rates were in India. By APC analysis, the age effect presented increase in 20-59 years in China, Japan and South Korea, 20-54 years in India and 20-64 years in Thailand; the period effect showed progressive increases in five countries, with the most significant increase shown in China; the cohort effect showed monotonic decreases with birth cohort in five countries.

CONCLUSIONS

Severe periodontitis poses a serious burden in Asian countries, especially China and India. We suggest raising people's awareness of periodontal health and providing professional interventions in these countries, especially for high-risk groups, such as younger people aged ≤65 years.

Prediction of cause-specific disability-adjusted life years in China from 2018 through 2021: a systematic analysis

OBJECTIVE

We aimed to predict population composition, mortality, sociodemographic index (SDI), and cause-specific disability-adjusted life year (DALY) rate in China from 2018 through 2021.

STUDY DESIGN

Using the time series method autoregressive integrated moving average (ARIMA) models on all available data, mainly Statistics Year Report by the Global Burden of Disease Study 2017, we predicted populations, deaths, DALYs attributable to disease conditions, and injuries (causes) for China from 2018 through 2021 at levels 0, 1, 2, and 3.

METHODS

The time series method ARIMA models was used on history data.

RESULTS

The predicted total population and SDI in China are increasing from 2018 through 2021. The under-5 mortality is decreasing; from 10.24% to 0.65% in the period 1990-2021. The all-cause DALY rate decreases. The top causes of DALY rate are non-communicable diseases (level 1), cardiovascular diseases (level 2), and stroke (level 3). For the leading 22 level 2 causes in 2018, the trend of ranking in 2021 is as follows: unchanged, 15; increasing, 4; and decreasing, 3. For the leading 169 level 3 causes in 2018, the trend of ranking in 2021 is: as follows: unchanged, 49; increasing, 63; and decreasing 57.

CONCLUSIONS

Cause-specific and time-dependent health policy should be steered to reduce the major burden focuses and to improve population health.

Association between IL-1A (-889C/T) polymorphism and susceptibility of chronic periodontitis: A meta-analysis

OBJECTIVE

The purpose of this study was to investigate the association between IL-1A (-889C/T, rs1800587) polymorphism and susceptibility of chronic periodontitis.

METHODS

A systematic literature search was carried out in the databases updated on July 1, 2019, including PubMed, Embase, Cochrane Library and Web of Science. Through STATA 14.0 software, the association between IL-1A (-889C/T) polymorphism and susceptibility of chronic periodontitis was calculated by pooled odds rations (ORs) and 95% confidence intervals (CIs). Harbord test was used for the publication bias.

RESULTS

The results of overall meta-analysis revealed that IL-1A (-889C/T) polymorphism was associated with the susceptibility of chronic periodontitis among all the genetic models, including allele contrast [T vs. C, OR (95% CI): 1.297 (1.038-1.622), P = 0.022], dominant model [TT + CT vs. CC, OR (95% CI): 1.337 (1.015-1.761), P = 0.039], recessive model [TT vs. CC + CT, OR (95% CI): 1.453 (1.138-1.856), P = 0.003], and codominant model [TT vs. CC, OR (95% CI): 1.555 (1.187-2.038), P = 0.001; CT vs. CC, OR (95% CI): 2.559 (1.245-5.260), P = 0.011]. The results of subgroup analyses indicated that IL-1A (-889C/T) polymorphism was closely related to the susceptibility of chronic periodontitis in African population [T vs. C, OR (95% CI): 1.277 (1.039-1.571), P = 0.020; TT + CT vs. CC, OR (95% CI): 1.357 (1.061-1.735), P = 0.015; TT vs. CC, OR (95% CI): 1.599 (1.115-2.292), P = 0.011], in European population [TT vs. CC + CT, OR (95% CI): 1.645 (1.112-2.435), P = 0.013; TT vs. CC, OR (95% CI): 1.639 (1.044-2.574), P = 0.032] and in American population [CT vs. CC, OR (95% CI): 6.404 (3.000-13.669), P < 0.001].

CONCLUSIONS

IL-1A (-889C/T) polymorphism is associated with the susceptibility of chronic periodontitis in African, European and American populations according to the currently available evidence.

Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

BACKGROUND

Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia.

METHODS

A total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software.

RESULTS

A total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26-2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75-6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30-2.64; periodontitis: OR = 4.83, 95% CI: 2.57-9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22-2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04-4.53), and there was a higher risk in the group with a prostate volume greater than 60 g.

CONCLUSION

Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.

Periodontal Disease Is Associated With Increased Risk of Hypertension: A Cross-Sectional Study

Objective: Published evidence showed that periodontal disease is associated with hypertension. However, relevant findings remain controversial, with few evidences focusing on Chinese population. Therefore, the aim of this study was to investigate the association between periodontal disease and hypertension in Chinese population.

Methods: A total of 4,930 participants from an available health examination that was carried out in 2017 were selected for this retrospective study. The correlations between periodontal disease and hypertension were investigated using univariate and multiple logistic regression analyses and propensity score adjusted analysis. Interaction and subgroup analyses were also used to detect variable factors.

Results: Finally, a total of 3,952 participants aged 30–68 years were eligible for this study. The results showed that hypertension risk was statistically significant associated with periodontal disease either in unadjusted (OR = 1.28, 95%CI = 1.14–1.47) or in adjusted (OR = 1.34, 95%CI = 1.14–1.58) model. Result from propensity score adjusted analysis also demonstrated a similar association (OR = 1.23, 95%CI = 1.06–1.42).

Conclusion: Periodontal disease is significantly and positively correlated with increased risk of hypertension in Chinese population, and exact mechanisms of this association should be explored in future.

DEFB1 rs11362 Polymorphism and Risk of Chronic Periodontitis: A Meta-Analysis of Unadjusted and Adjusted Data

Objective: Chronic periodontitis (CP) is a growing problem that affects the worldwide population, having significant impacts on people's daily lives and economic development. Genetics is an important component in the determination of individual susceptibility to periodontal diseases. Numerous studies have been performed to investigate the association between beta defensin 1 (DEFB1) rs11362 polymorphism and risk of CP, but the results are still inconclusive. Therefore, we conducted this meta-analysis to ascertain whether this variation in DEFB1 is associated with CP susceptibility.

Methods: The relevant studies were searched in PubMed and Chinese National Knowledge Infrastructure (CNKI) databases up to January 9, 2018. Two independent authors selected citations and extracted the data from eligible studies. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were used to assess the strength of the association.

Results: Seven case-control studies were included in this meta-analysis. Based on unadjusted data, there was no obvious association between DEFB1 rs11362 polymorphism and CP risk in all genetic models (A vs. G: OR = 0.86, 95%CI = 0.61–1.20; AA vs. GG: OR = 0.83, 95% CI = 00.50–1.39; AG vs. GG: OR = 1.01, 95%CI = 0.73–1.39; AG+AA vs. GG: OR = 0.91, 95% CI = 00.74–1.11; and AA vs. AG+GG: OR = 0.83, 95% CI = 00.57–1.21); the results of adjusted data also showed no significant relationship. Subgroup analyses based on ethnicity, participants' smoking status, HWE in controls and severity of CP all revealed similar results to that of the overall analysis. Sensitivity analysis indicated the results were robust and no evidence of publication bias was found.

Conclusions: Our meta-analysis suggests that DEFB1 rs11362 polymorphism may not have an important effect on the risk of CP. Further large-scale and well-designed studies are necessary to validate our conclusion in the future.

Assessment of cardiac biomarkers (troponin, B-type natriuretic peptide, and D-dimer) in patients with non-valvular atrial fibrillation and stroke

OBJECTIVES

Atrial fibrillation (AF) is the most common arrhythmia treated in clinical practice and the association of this arrhythmia with stroke has long been recognized. The combination of associated factors to identify stroke risk is still unclear; therefore, we aimed to determine the association between additional risk factors for non-valvular AF (NVAF) and the first onset stroke patients and investigate the predictive ability of additional risks factors such as cardiac biomarkers and AF status for odds of incident stroke.

MATERIALS AND METHODS

We included 455 patients who suffered from NVAF divided into two distinct groups (case-control observational study). Those two groups were based on whether the patients were having a first onset stroke (stroke group) or not having a stroke (non-stroke group). We made the baseline characteristic of our sample group from the substantial evidence of risk factors, lifestyle, and type of AF; to controversial risk described in the new international guideline of AF.

RESULTS

Statistically revealed that heart failure, coronary disease, cigarette smoking, type of AF, warfarin treatment, high sensitive troponin, and B-type natriuretic peptide (BNP) are associated with stroke in NVAF patients (P < 0.05). Otherwise, age, sex, hypertension, kidney disease, diabetes, thyroid disease, alcohol intake, season, aspirin, and D-dimer medication were not associated with stroke (P > 0.05). Multivariate analysis of age, smokers, coronary heart disease, heart failure, high sensitive troponin level, BNP, permanent AF, and warfarin was associated (P < 0.05). The combination of biomarkers with the clinical features can be useful (CHA2DS2-VASC/BS) for the prediction of stroke than CHA2DS2-VASC alone (P < 0.05).

CONCLUSION

Impact of all associated factors and biological markers as additional risk factors may carry a synergy in this life-threatening event. In addition, may hold a clinical role to redefine and predict stroke events better than the current CHA2DS2-VASC.

Periodontal Disease and Risk of Bladder Cancer: A Meta-Analysis of 298476 Participants

Objective: It has been reported that the periodontal disease is linked to a number of malignant tumors such as lung cancer and pancreatic cancer. In this study, we aimed to investigate the association of periodontal disease with risk of bladder cancer by a meta-analysis.

Methods: PubMed, Scopus, ScienceDirect, and Chinese National Knowledge Infrastructure (CNKI) were searched for eligible publications up to December 15, 2017. Cohort and nested case-control studies on the association between periodontal disease and risk of bladder cancer were included. After study selection and data extraction, pooled hazard ratios (HRs) and their 95% confidence intervals (95%CIs) were calculated using a fixed-effect inverse-variance model. All analyses were performed using the RevMan 5.3 software.

Results: Finally, five cohort studies were identified and included in this meta-analysis, involving 1,104 bladder cancer cases of 298,476 participants. Summary estimates based on adjusted data showed that periodontal disease was not significantly associated with the risk of bladder cancer (HR = 1.09, 95% CI = 0.95–1.25, I² = 0%). A similar result was also observed after cumulative, subgroup and sensitivity analyses.

Conclusions: Current evidence from cohort studies suggests that patients with periodontal disease may not be at an increased risk of developing bladder cancer.

Effect of a comprehensive plan for periodontal disease care on oral health-related quality of life in patients with periodontal disease in Taiwan

A comprehensive plan for periodontal disease (PD) care in Taiwan provides non-surgical and supportive periodontal treatment. The aim of this study was to determine whether the care plan could improve the oral health-related quality of life of patients with PD.This study was conducted by purposive sampling and a quasi-experimental design. Patients with PD were assigned to either comprehensive periodontal treatment (n = 32) or a simple cleaning regimen (n = 32). Their oral health-related quality of life (OHRQoL) was measured using the Taiwanese version of the Brief World Health Organization Quality of Life (WHOQOL-BREF) scale (general QoL) and the Oral Health Impact Profile (OHIP-14) (OHRQoL). Both scales were completed 14, 28, and 90 days after the initial assessment. The extent of PD in the experimental group was determined again at the end of the study.On the 28-item WHOQOL-BREF scale, the scores of the experimental group were higher than those of the control group on 5 items and the environmental domain at 14 days. There was a significant improvement in the experimental group on 2 items at 28 days and at 90 days after periodontal treatment (both P < .05). No difference was found between the 2 groups in score on the OHIP-14; however, there was a significant improvement in the experimental group in total score at 28 and 90 days after periodontal treatment (both P < .05). The number of teeth with probing depth ≥5 mm and the percentage of dental plaque were both significantly reduced after the intervention (both P < .001).Patients with a comprehensive plan for PD care showed some improvement in QoL, including in the environmental domain, and on the total score for OHRQoL. Comprehensive periodontal treatment also alleviated periodontal symptoms.