Background/Purpose: To examine whether the association between periodontitis (PD) history and the rheumatoid arthritis (RA) risk differs between individuals with and without diabetes mellitus (DM).

Methods: We conducted a population-based retrospective cohort study using the 1997–2009 National Health Insurance (NHI) claims data of one million representative individuals from all NHI enrollees. Adults with DM (aged ≥20 years) newly treated during 2001–2009 were classified as DM subjects and those without a DM diagnosis during 1997–2009 were classified as non-DM subjects. We identified 7097 DM subjects with PD history within one year before initiating anti-diabetes treatment (index date). By matching these 7097 subjects for age on the index date, sex, and year of the index date, we randomly extracted 14,194 DM subjects without PD history, 14,194 non-DM subjects with PD history, and 28,388 non-DM subjects without PD history. Adjusted hazard ratios (aHRs) with a 95% confidence interval (CI) were calculated by applying Cox proportional hazards models to quantify the association between PD history and RA risk.

Results: Compared with subjects without PD history, the adjusted HR of RA among those with PD history was 2.26 (95%CI, 1.26–4.04). In subgroup analysis, this association was evident among DM subjects (aHR, 3.77; 95%CI, 1.48–9.60) but not among non-DM subjects (aHR, 1.56; 95%CI, 0.73–3.37; P for interaction 0.212).

Conclusion: The effect of PD exposure on RA risk was evident in newly treated DM subjects but not in non-DM subjects; no significant modifying effect of DM was observed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-history-of-periodontitis-and-risk-of-rheumatoid-arthritis-in-individuals-with-and-without-diabetes-mellitus-a-population-based-cohort-study/