Periodontal disease is associated with the risk of cardiovascular disease independent of sex: A meta-analysis

Leng, Yurong; Hu, Qinwen; Qin, Ling; Yao, Xiongda; Liu, Menglu; Chen, Jiawei; Yan, Zhiwei; Dai, Qun

doi:10.3389/fcvm.2023.1114927

Cited by 25 publications

(8 citation statements)

References 68 publications

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“…Finally, the effect estimates for the relation between PD and cardiac death in the subgroups of Western countries, PD with clinical diagnosed, and follow-up duration � 10.0 years were larger than corresponding subgroups. Several systematic review and meta-analyses have already investigated the role of PD with the risk of cardiovascular outcomes and all-cause mortality [13][14][15]. Larvin et al identified 30 cohort studies and found the MACEs risk was significantly elevated in PD patients, and the risk increased highest was stroke [13].…”

Section: Discussionmentioning

confidence: 99%

“…Qin et al performed a meta-analysis of 10 cohort studies and found PD was associated with an increased risk of MI, while this association could affected by sex, effect value, survey form, and study quality [14]. Leng et al identified 26 studies and found significant association between PD and MACEs in both men and women [15]. However, several other important outcomes, including cardiac death, and all-cause mortality were PLOS ONE not investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, more and more attention has been paid to the association of PD with the risk of cardiovascular outcome and all-cause mortality. Several systematic review and meta-analyses were performed to assess the association between PD with the risk of cardiovascular outcomes [12][13][14][15], whereas the exploratory analyses for these relationship remained unclear. Therefore, we conducted this systematic review and meta-analysis to evaluate the association of PD with the risk of cardiovascular outcome and all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

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Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies

Guo,

Li,

Liao

et al. 2023

PLoS ONE

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Studies reported periodontal disease (PD) periodontal disease is associated with many systemic diseases, including cardiovascular outcomes and all-cause mortality. However, the precise mechanistic link for these relationship remained unclear. We therefore performed a meta-analysis of cohort studies to investigate the association of PD with the risk of cardiovascular outcomes and all-cause mortality. We systematically searched the databases of PubMed, EmBase, and the Cochrane library to identify eligible studies until April 2023. The investigated outcomes included major adverse cardiovascular events (MACEs), coronary heart disease (CHD), myocardial infarction (MI), stroke, cardiac death, and all-cause mortality. The summary relative risk (RR) with 95% confidence interval (CI) were calculated using the random-effects model. Thirty-nine cohort studies with 4,389,263 individuals were selected for final meta-analysis. We noted PD were associated with elevated risk of MACEs (RR: 1.24; 95%CI: 1.15–1.34; P<0.001), CHD (RR: 1.20; 95%CI: 1.12–1.29; P<0.001), MI (RR: 1.14; 95%CI: 1.06–1.22; P = 0.001), stroke (RR: 1.26; 95%CI: 1.15–1.37; P<0.001), cardiac death (RR: 1.42; 95%CI: 1.10–1.84; P = 0.007), and all-cause mortality (RR: 1.31; 95%CI: 1.07–1.61; P = 0.010). Sensitivity analyses indicated the pooled conclusions for cardiovascular outcomes and all-cause mortality are robustness. The associations of PD with the risk of ardiovascular outcomes and all-cause mortality could affected by region, study design, PD definition, follow-up duration, and study quality. This study found the risk of cardiovascular outcomes and all-cause mortality were elevated in PD patients, and the intervention for PD should be applied to prevent the risk of cardiovascular outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies

Guo,

Li,

Liao

et al. 2023

PLoS ONE

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“…A recent systematic review suggested a 7.2% prevalence of CVD and its significant association in men (OR = 1.22) and women (OR = 1.11) with periodontal disease[ 6 ]. The highly vascular nature of gums and periodontal issues result in the dissemination of bacteria and their toxins into circulation regularly.…”

Section: Pathophysiology Of Periodontitis and Systemic Diseasesmentioning

confidence: 99%

Periodontitis: An often-neglected complication of diabetes

Kudiyirickal,

Pappachan

2024

World J Diabetes

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The bidirectional association between type 2 diabetes mellitus (T2DM) and periodontitis is now well established, resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus (DM) after car-diovascular disease, eye disease, neuropathy, nephropathy, and peripheral vascular disease. DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease. On the other hand, the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM. Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss. A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM. The prevalence of periodontitis was found to be 75.7% in this study. Based on logistic regression analysis, the predictive factors for higher risk were low tooth brushing frequency [odds ratio (OR) = 4.3], high triglycerides (TG; OR = 3.31), high total cholesterol (TC; OR = 2.87), higher glycated hemoglobin (HbA1c; OR = 2.55), and higher age (OR = 1.05) while higher education level was protective (OR = 0.53). However, the most influential variables were HbA1c followed by age, TC, TG, low education level, brushing frequency, and sex on the random forest model (this model showed higher sensitivity for predicting the risk). A good understanding of the predictors for periodontitis in T2DM patients is important in prevention, early detection of susceptible patients, and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al .

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“…This is a disease with a complex pathogenesis, in which pathogens, commensals, and host oral autoimmunity dysfunction are involved [ 31 ]. PD was frequently proposed as a risk factor in various systemic disorders, like diabetes [ 30 , 32 ], cardiovascular [ 33 ] and respiratory diseases [ 34 ], adverse pregnancy outcomes [ 35 ], and rheumatic diseases, including RA. Research on this topic indicates that there is a higher prevalence of PD among RA patients [ 36 , 37 ].…”

Section: The Connection Between Periodontal Disease and Rheumatoid Ar...mentioning

confidence: 99%

Infectious and Commensal Bacteria in Rheumatoid Arthritis—Role in the Outset and Progression of the Disease

Korzeniowska,

Bryl

2024

IJMS

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Rheumatoid arthritis (RA) is a chronic, autoimmune disease with a complex outset. Besides the genetic susceptibility in its pathogenesis, various environmental factors also participate. Of these, in recent years, there have been increasing reports of the involvement of bacteria in the disease’s outset and development, especially gut microbiota and oral pathogens. Most recent reports about bacteria participation in RA pathogenesis focus on Prevotella copri and Porphyromonas gingivalis. There are also reports about the involvement of respiratory and urinary tract pathogens. The exact mechanisms leading to RA development used by bacteria are not well known; however, some mechanisms by which bacteria can interact with the immune system are known and can potentially lead to RA development. The aim of this study is to provide a comprehensive review of the potential bacteria participating in RA development and the mechanism involved in that process.

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Periodontal disease is associated with the risk of cardiovascular disease independent of sex: A meta-analysis

Cited by 25 publications

References 68 publications

Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies

Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies

Periodontitis: An often-neglected complication of diabetes

Infectious and Commensal Bacteria in Rheumatoid Arthritis—Role in the Outset and Progression of the Disease

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