DOI QR코드

DOI QR Code

Association of periodontitis with menopause and hormone replacement therapy: a hospital cohort study using a common data model

  • Ki-Yeol Park (Department of Periodontology, Ewha Womans University Mokdong Hospital) ;
  • Min-Ho Kim (Informatization Department, Ewha Womans University Seoul Hospital) ;
  • Seong-Ho Choi (Department of Periodontology, College of Dentistry, Yonsei University) ;
  • Eun-Kyoung Pang (Department of Periodontology, Ewha Womans University Mokdong Hospital)
  • Received : 2022.05.15
  • Accepted : 2022.10.12
  • Published : 2023.06.30

Abstract

Purpose: The present study was designed to compare the incidence of periodontitis according to menopausal status and to investigate the possible effect of hormone replacement therapy (HRT) on periodontitis in postmenopausal women using a common data model (CDM) at a single institution. Methods: This study involved retrospective cohort data of 950,751 patients from a 20-year database (2001 to 2020) of Ewha Womans University Mokdong Hospital converted to the Observational Medical Outcomes Partnership CDM. One-way analysis of variance models and the χ2 test were used to analyze the statistical differences in patient characteristics among groups. A time-dependent Cox regression analysis was used to calculate hazard ratios and 95% confidence intervals, and P values less than 0.05 were considered to indicate statistical significance. Results: Of the 29,729 patients, 1,307 patients were diagnosed with periodontitis and 28,422 patients were not. Periodontitis was significantly more common among postmenopausal patients regardless of HRT status than among the non-menopausal group (P<0.05). Time-dependent Cox regression analysis showed that the postmenopausal patients had a significantly higher chance of having periodontitis than non-menopausal patients (P<0.05), but after adjustment for age, body mass index, and smoking status, the difference between the non-menopausal and post-menopausal HRT-treated groups was insignificant (P=0.140). Conclusions: Postmenopausal women had a significantly greater risk of periodontitis than non-menopausal women. Additionally, the use of HRT in postmenopausal women could reduce the incidence of periodontitis.

Keywords

References

  1. Albandar JM. Global risk factors and risk indicators for periodontal diseases. Periodontol 2000 2002;29:177-206. https://doi.org/10.1034/j.1600-0757.2002.290109.x
  2. Nikolaou D, Gilling-Smith C. Early ovarian ageing: are women with polycystic ovaries protected? Hum Reprod 2004;19:2175-9. https://doi.org/10.1093/humrep/deh419
  3. Bromberger JT, Matthews KA, Kuller LH, Wing RR, Meilahn EN, Plantinga P. Prospective study of the determinants of age at menopause. Am J Epidemiol 1997;145:124-33. https://doi.org/10.1093/oxfordjournals.aje.a009083
  4. Burger HG, Dudley EC, Robertson DM, Dennerstein L. Hormonal changes in the menopause transition. Recent Prog Horm Res 2002;57:257-75. https://doi.org/10.1210/rp.57.1.257
  5. Friedlander AH. The physiology, medical management and oral implications of menopause. J Am Dent Assoc 2002;133:73-81. https://doi.org/10.14219/jada.archive.2002.0025
  6. Reinhardt RA, Payne JB, Maze CA, Patil KD, Gallagher SJ, Mattson JS. Influence of estrogen and osteopenia/osteoporosis on clinical periodontitis in postmenopausal women. J Periodontol 1999;70:823-8. https://doi.org/10.1902/jop.1999.70.8.823
  7. Lerner UH. Bone remodeling in post-menopausal osteoporosis. J Dent Res 2006;85:584-95. https://doi.org/10.1177/154405910608500703
  8. Guiglia R, Di Fede O, Lo Russo L, Sprini D, Rini GB, Campisi G. Osteoporosis, jawbones and periodontal disease. Med Oral Patol Oral Cir Bucal 2013;18:e93-9. https://doi.org/10.4317/medoral.18298
  9. Zhao H, Li C, Lin L, Pan Y, Wang H, Zhao J, et al. Assessment of alveolar bone status in middle aged Chinese (40-59 years) with chronic periodontitis-using CBCT. PLoS One 2015;10:e0139553.
  10. Alves RC, Felix SA, Rodriguez-Archilla A, Oliveira P, Brito J, Dos Santos JM. Relationship between menopause and periodontal disease: a cross-sectional study in a Portuguese population. Int J Clin Exp Med 2015;8:11412-9.
  11. Haas AN, Rosing CK, Oppermann RV, Albandar JM, Susin C. Association among menopause, hormone replacement therapy, and periodontal attachment loss in southern Brazilian women. J Periodontol 2009;80:1380-7.  https://doi.org/10.1902/jop.2009.090082
  12. Lobo RA, Pickar JH, Stevenson JC, Mack WJ, Hodis HN. Back to the future: hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis 2016;254:282-90. https://doi.org/10.1016/j.atherosclerosis.2016.10.005
  13. Cagnacci A, Venier M. The controversial history of hormone replacement therapy. Medicina (Kaunas) 2019;55:602.
  14. de Villiers TJ, Gass ML, Haines CJ, Hall JE, Lobo RA, Pierroz DD, et al. Global consensus statement on menopausal hormone therapy. Climacteric 2013;16:203-4. https://doi.org/10.3109/13697137.2013.771520
  15. Hripcsak G, Duke JD, Shah NH, Reich CG, Huser V, Schuemie MJ, et al. Observational Health Data Sciences and Informatics (OHDSI): opportunities for observational researchers. Stud Health Technol Inform 2015;216:574-8.
  16. Voss EA, Makadia R, Matcho A, Ma Q, Knoll C, Schuemie M, et al. Feasibility and utility of applications of the common data model to multiple, disparate observational health databases. J Am Med Inform Assoc 2015;22:553-64. https://doi.org/10.1093/jamia/ocu023
  17. Makadia R, Ryan PB. Transforming the premier perspective® hospital database into the observational medical outcomes partnership (OMOP) common data model. EGEMS (Wash DC) 2014;2:1110.
  18. Yoon D, Ahn EK, Park MY, Cho SY, Ryan P, Schuemie MJ, et al. Conversion and data quality assessment of electronic health record data at a Korean tertiary teaching hospital to a common data model for distributed network research. Healthc Inform Res 2016;22:54-8. https://doi.org/10.4258/hir.2016.22.1.54
  19. Biedermann P, Ong R, Davydov A, Orlova A, Solovyev P, Sun H, et al. Standardizing registry data to the OMOP Common Data Model: experience from three pulmonary hypertension databases. BMC Med Res Methodol 2021;21:238.
  20. Garza M, Del Fiol G, Tenenbaum J, Walden A, Zozus MN. Evaluating common data models for use with a longitudinal community registry. J Biomed Inform 2016;64:333-41. https://doi.org/10.1016/j.jbi.2016.10.016
  21. Liyanage H, Liaw ST, Jonnagaddala J, Hinton W, de Lusignan S. Common data models (CDMs) to enhance international big data analytics: a diabetes use case to compare three CDMs. Stud Health Technol Inform 2018;255:60-4.
  22. Ronderos M, Jacobs DR, Himes JH, Pihlstrom BL. Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol 2000;27:778-86. https://doi.org/10.1034/j.1600-051x.2000.027010778.x
  23. Pizzo G, Guiglia R, Licata ME, Pizzo I, Davis JM, Giuliana G. Effect of hormone replacement therapy (HRT) on periodontal status of postmenopausal women. Med Sci Monit 2011;17:PH23-7. https://doi.org/10.12659/MSM.881700
  24. Grossi SG. Effect of estrogen supplementation on periodontal disease. Compend Contin Educ Dent Suppl 1998;S30-6.
  25. Lee Y, Kim I, Song J, Hwang KG, Choi B, Hwang SS. The relationship between hormone replacement therapy and periodontal disease in postmenopausal women: a cross-sectional study the Korea National Health and Nutrition Examination Survey from 2007 to 2012. BMC Oral Health 2019;19:151.
  26. Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007;78:1387-99. https://doi.org/10.1902/jop.2007.060264
  27. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6. https://doi.org/10.1902/annals.1999.4.1.1
  28. Greendale GA, Lee NP, Arriola ER. The menopause. Lancet 1999;353:571-80. https://doi.org/10.1016/S0140-6736(98)05352-5