title: Association between History of Dental Amalgam Fillings and Risk of Parkinson's Disease: A Population-Based Retrospective Cohort Study in Taiwan.
abstract: The impact of dental amalgam on the development of Parkinson's disease (PD) is still uncertain, although a positive association between dental amalgam and PD has been found in a few case-control studies. The patients with amalgam fillings restored between 2000 and 2008 were identified by using the National Health Insurance Research Database (NHIRD) in Taiwan. The same number of patients who had no new amalgam filling restored was matched by sex, age, and treatment date. Both cohorts were followed up from the treatment date until the date of diagnosis of PD, death, or the end of the year 2008. The individuals who received amalgam fillings had a significantly higher risk of PD afterward (adjusted hazard ratio [HR]=1.583, 95% confidence interval [CI]=1.122-2.234, p=0.0089) than those who did not. In the individuals who received amalgam fillings, being diagnosed with diabetes or hyperlipidemia demonstrated a significantly lower HR of PD occurrence than in the patients without diabetes or hyperlipidemia (HR=0.449, 95% CI=0.254-0.794, p=0.0059; HR=0.445, 95% CI=0.260-0.763, p=0.0032) after adjusting for comorbidities and Charlson-Deyo Comorbidity Index (CCI) scores. Meanwhile, hypertension increased the hazard risk of PD (HR=1.645, 95% CI=1.098-2.464, p=0.0159). The patients exposed to dental amalgam fillings were 1.583 times more likely to have PD afterward compared to their non-exposed counterparts after adjusting for comorbidities and CCI scores.
authors.affiliation: Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yung-Chuang
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Department of Information Management, Hsing Wu University, New Taipei City, Taiwan.
authors.forename: Cheng-Wei
authors.initials: CW
authors.lastname: Chang
authors.affiliation: Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hsin-Lin
authors.initials: HL
authors.lastname: Lee
authors.affiliation: Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chuan-Chung
authors.initials: CC
authors.lastname: Chuang
authors.affiliation: Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hsien-Chung
authors.initials: HC
authors.lastname: Chiu
authors.affiliation: Department of Computer Science and Information Engineering, National Central University, Chungli, Taiwan.
authors.forename: Wan-Yun
authors.initials: WY
authors.lastname: Li
authors.affiliation: Department of Computer Science and Information Engineering, National Central University, Chungli, Taiwan.|Population-Health and Clinical Informatics Research Group, Department of Biomedical Informatics, Asia University Taiwan, Taichung, Taiwan.
authors.forename: Jorng-Tzong
authors.initials: JT
authors.lastname: Horng
authors.affiliation: Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Earl
authors.initials: E
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003723:Dental Amalgam / Q000009:adverse effects* / Q000627:therapeutic use / Q000633:toxicity; D005260:Female; D006801:Humans; D008297:Male; D008628:Mercury / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000453:epidemiology* / Q000473:pathology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan
chemical_list: D003723:Dental Amalgam; D008628:Mercury