Abstract：
OBJECTIVE: To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort.
METHODS: Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.
RESULTS: A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant.
CONCLUSIONS: Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
METHODS: Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.
RESULTS: A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant.
CONCLUSIONS: Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
摘要：
目的：探讨口腔健康与抑郁症的关系，英国生物银行队列中的焦虑及其合并症。
方法：在基线时自我报告口腔健康问题。在一项横断面研究中，使用心理健康问卷（PHQ-4）评估了抑郁和焦虑的症状。在队列研究中，抑郁症和焦虑症的诊断基于医院记录.采用Logistic回归和Cox回归模型分析口腔健康与抑郁/焦虑的关系。
结果：共有305,188名参与者被纳入横断面研究，多因素分析显示牙周病与抑郁和/或焦虑相关(比值比[OR]:1.79,95%置信区间[CI]:1.73~1.86).在涉及264,706名参与者的前瞻性队列研究中，牙周病与抑郁和/或焦虑风险增加显著相关(风险比[HR]:1.14,95%CI:1.10-1.19),抑郁（HR：1.19，95%CI：1.13-1.25）和焦虑（HR：1.13，95%CI：1.07-1.19）。牙周病也与抑郁和焦虑合并症显著相关(HR:1.27,95%CI:1.16-1.38)。使用基线炎症因子的多重中介分析显示，白细胞计数和C反应蛋白解释了牙周病与抑郁和焦虑之间的相关性的3.07%和3.15%，分别。然而,首次随访时炎性因子的纵向多重介导分析结果(N=10,673)不显著.
结论：发现牙周病与抑郁症风险增加有关，焦虑和他们的共病。
方法：在基线时自我报告口腔健康问题。在一项横断面研究中，使用心理健康问卷（PHQ-4）评估了抑郁和焦虑的症状。在队列研究中，抑郁症和焦虑症的诊断基于医院记录.采用Logistic回归和Cox回归模型分析口腔健康与抑郁/焦虑的关系。
结果：共有305,188名参与者被纳入横断面研究，多因素分析显示牙周病与抑郁和/或焦虑相关(比值比[OR]:1.79,95%置信区间[CI]:1.73~1.86).在涉及264,706名参与者的前瞻性队列研究中，牙周病与抑郁和/或焦虑风险增加显著相关(风险比[HR]:1.14,95%CI:1.10-1.19),抑郁（HR：1.19，95%CI：1.13-1.25）和焦虑（HR：1.13，95%CI：1.07-1.19）。牙周病也与抑郁和焦虑合并症显著相关(HR:1.27,95%CI:1.16-1.38)。使用基线炎症因子的多重中介分析显示，白细胞计数和C反应蛋白解释了牙周病与抑郁和焦虑之间的相关性的3.07%和3.15%，分别。然而,首次随访时炎性因子的纵向多重介导分析结果(N=10,673)不显著.
结论：发现牙周病与抑郁症风险增加有关，焦虑和他们的共病。
