Systemic inflammation and the relationship between periodontitis, edentulism, and all‐cause mortality: A 17‐year prospective cohort study

Abstract

Aim The aim was to investigate the role of systemic inflammation in the relationship between periodontitis, edentulism, and all‐cause mortality in a group of men in Northern Ireland aged 58–72 years. Materials and methods A representative sample of 1558 men had a detailed dental examination between 2001 and 2003. The primary end point was death from any cause. Cox's proportional hazards model was used to assess the longitudinal relationship between periodontitis, edentulism, and all‐cause mortality. Accelerated failure time modelling was performed to investigate the mediating role of systemic inflammation. Results Mean age of the men at baseline was 64.3 (standard deviation 2.9) years. During a median follow‐up of 17 years, 500 (32.1%) men died. After adjustment for confounding variables, compared to men with no/mild periodontitis, edentulous men had a hazard ratio for all‐cause mortality of 1.52 (95% confidence interval [CI] 1.16–1.99) p < .01 and for those with severe periodontitis, it was 1.34 (95% CI 1.06–1.70) p = .01. Systemic inflammation accounted only for a minor mediating pathway effect of 10%. Conclusions There was evidence in this group of men that those who were edentulous or had severe periodontitis had a significantly increased risk of all‐cause mortality. Systemic inflammation was not a major explanatory mediator of this association.

The additive effect of periodontitis with hypertension on risk of systemic disease and mortality

“…12,26 A recent study also found that systemic inflammation only accounts for 10% of the mediating pathway effect that links PD with an increased risk of all-cause mortality. 27 Other findings suggest that PD treatment may also improve the efficacy of antihypertensive medication; although this study was limited to cross-sectional data, and the impact to subsequent systemic disease outcomes was not explored. 28 More robust research is needed to improve understanding of the biological mechanism that underpins the causal association between PD, hypertension, and systemic disease.…”

“…The latter authors suggest that PD treatment may reduce inflammation in hypertensive participants, 13 although the research regarding CRP as an inflammatory mediator between PD and hypertension is controversial 12,26 . A recent study also found that systemic inflammation only accounts for 10% of the mediating pathway effect that links PD with an increased risk of all‐cause mortality 27 . Other findings suggest that PD treatment may also improve the efficacy of antihypertensive medication; although this study was limited to cross‐sectional data, and the impact to subsequent systemic disease outcomes was not explored 28 .…”

Association of TGFB1 rs1800469 and BCMO1 rs6564851 with coronary heart disease and IL1B rs16944 with all-cause mortality in men from the Northern Ireland PRIME study

“…The BSO uses death registration information supplied by the NI Register General Office and other sources to link data on all deaths in NI to the master patient index. The BSO provides six monthly updates on the deaths of participants in the cohort who are flagged on their system [ 39 ]. The end of follow-up date for mortality was November 30 th , 2020.…”

“…The majority of the genetic information was obtained from blood samples taken at rescreen. If a blood sample was unavailable from rescreen, residual blood from baseline samples was used for genotyping in a small number of cases [ 39 ].…”

Periodontitis, Helicobacter pylori infection, and gastrointestinal tract cancer mortality

“…Poverty-income ratios (PIRs) were collected and categorized according to the ratio of family income to poverty thresholds. These other covariates were determined because they have been proposed as confounding factors between periodontitis and mortality (Winning et al, 2021;Wu et al, 2021).…”