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P753 Increased risk of ulcerative colitis in patients with periodontitis: a nationwide population-based study

J. S. Kim*1, E. A. Kang1, K. Han2, J. Kim3, J. P. Im1, J. Chun1, H. Soh1, S. Park1

1Seoul National University College of Medicine, Department of Internal Medicine, Seoul, South Korea, 2the Catholic University of Korea, Seoul St. Mary's Hospital, Department of Medical Statistics, Seoul, South Korea, 3Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Department of Internal Medicine, Seoul, South Korea

Background

Periodontitis is a chronic inflammatory status of periradicular tissues caused by an infection of endodontic origin. Periodontitis is caused by the interaction between microbiota in the root canal and host immune system. Periodontitis can occur in patients with inflammatory bowel disease (IBD) treated with immunomodulators or biologic agents. However, the effect of periodontitis on IBD is unclear. The aim of this study was to assess the risk of IBD in patients with periodontitis.

Methods

We performed a nationwide, population-based study using claim data from the National Healthcare Insurance Service-National Health Screening Program in Korea. Included were people aged 20 or older who participated in the national health screening program at least once in the index year 2009 (n = 9,950.548). Periodontitis was defined as diagnosed within 2 years before the index year according to ICD-10 code. We compared patients with periodontitis to individuals without periodontitis matched by age, sex and body mass index (BMI). The end point was newly diagnosed IBD that met both of ICD-10 codes (K50 for Crohn’s disease (CD) and K51 for ulcerative colitis (UC)) and V code for rare intractable diseases (V130 for CD and V131 for UC) until December 31th, 2017. We exclude IBD patients who were diagnosed within 1 year from the index year (lag period).

Results

Patients with periodontitis had higher risk of UC than populations without periodontitis matched by age, sex, smoking, drinking, physical activity and BMI (Hazard ratio [HR], 1.090; Confidence interval [CI], 1.022–1.162; p < 0.0001). According to a subgroup analysis of the periodontitis group, the risk of UC was significantly higher in patients who were over 50 years old, heavy drinkers and current smokers (HR, 1.987; CI, 1.123–3.515). However, the risk of CD in patients with periodontitis was not increased compared with the general population.

Conclusion

Patients with periodontitis are at an increased risk of UC compared with individuals without periodontitis.