Research Outline
Research Questions:
Do individuals with chronic respiratory diseases (CRDs) have an elevated risk of developing incident periodontitis?
To what extent is this association mediated by systemic inflammation, metabolic dysregulation, and genetic susceptibility?
Objectives:
To establish a longitudinal cohort within the UK Biobank to compare the risk of new-onset periodontitis between participants with and without baseline CRDs (COPD/asthma).
To quantify the association using Cox proportional hazards models, adjusting for key confounders (e.g., age, sex, smoking, socioeconomic status).
To perform causal mediation analysis to decompose the total effect into direct and indirect effects via biomarkers (e.g., CRP, white cell count, TyG index) and polygenic risk scores.
Scientific Rationale:
Epidemiological links between periodontitis and CRDs are established, but causal direction and mechanisms remain poorly defined in human populations. The aspiration of oral pathogens and systemic inflammation are hypothesised as key pathways. This study leverages the UK Biobank’s prospective design, extensive phenotyping, and biomarker data to move beyond correlation. By establishing a temporal sequence (CRD preceding periodontitis) and quantifying the role of mediators, we can provide robust evidence for the nature of this relationship. This will clarify the underlying biology, particularly the shared pathways of systemic inflammation and metabolic dysregulation, and could inform integrated screening and management strategies for these common chronic conditions.