The Risk of Cardiometabolic Conditions Among Patients With Oral Candidiasis: A Global Large-Scale Population-Based Study

Background: The cardiometabolic burden of oral candidiasis (OC) is yet to be thoroughly elucidated. Objective: To assess the risk of long-term cardiovascular and metabolic outcomes in patients with OC relative to those with two other common oral conditions: herpes simplex virus (HSV) infections and recurrent aphthous stomatitis (RAS). Methods: A global retrospective cohort study comprised two analyses comparing patients with OC to those with HSV and RAS. The study groups were compared regarding the risk of 11 different cardiovascular and four metabolic outcomes. Propensity score matching was performed to optimize inter-group comparability. Results: Relative to those with HSV infections, patients with OC were found to experience a higher risk of stroke (HR, 1.78; 95% CI, 1.65–1.92), sudden cardiac death (HR, 2.46; 95% CI, 2.14–2.82), congestive heart failure (CHF; HR, 1.92; 95% CI, 1.80–2.06), hypertension (HR, 1.56; 95% CI, 1.50–1.62), hyperlipidemia (HR, 1.18; 95% CI, 1.13–1.24), type-2 diabetes mellitus (DM; HR, 1.72; 95% CI, 1.63–1.81), and obesity (HR, 1.32; 95% CI, 1.27–1.38). Compared to RAS, OC demonstrated an elevated risk of myocardial infarction (HR, 1.47; 95% CI, 1.40–1.54), stroke (HR, 1.30; 95% CI, 1.25–1.36), pulmonary embolism (HR, 2.23; 95% CI, 2.11–2.35), peripheral vascular disease (HR, 1.35; 95% CI, 1.29–1.41), atrial fibrillation (HR, 1.61; 95% CI, 1.55–1.68), CHF (HR, 1.79; 95% CI, 1.73–1.86), hyperlipidemia (HR, 1.36; 95% CI, 1.33–1.40), DM (HR, 1.44; 95% CI, 1.40–1.48), and obesity (HR, 1.30; 95% CI,1.27–1.34). Conclusion: OC is associated with an elevated risk of cardiometabolic outcomes. Physicians managing patients with OC should be aware of these associations.