Published online May 26, 2013. doi: 10.13105/wjma.v1.i1.47
Revised: April 4, 2013
Accepted: May 7, 2013
Published online: May 26, 2013
AIM: To investigate whether periodontal disease (PD) is associated with increasing coronary heart disease (CHD) risk by performing a meta-analysis.
METHODS: Two authors independently searched PubMed and China National Knowledge Infrastructure up to January 10th, 2013 for relevant case-control studies that investigated the association between PD and CHD. After quality assessment using Newcastle-Ottawa Scale and data extraction by two independent authors, the overall and subgroup meta-analyses were performed and publication bias were examined using the Comprehensive Meta-Analysis V2 software. Potential publication bias was assessed using visual inspection of the funnel plots, Egger linear regression test, and trims and fill method.
RESULTS: Finally 38 relevant case-control studies were identified, involving 4950 CHD patients and 5490 controls. Eleven studies were rated low quality and 27 were high quality. Based on random-effects, a significant association was identified between PD and CHD (OR 3.79, 95%CI: 2.23-6.43, P < 0.001, I2 = 98.59%), and sensitivity analysis showed that this result was robust. Subgroup analyses according to adjusted/unadjusted ORs, source of control, methodological quality, end point, assessment of PD/CHD, and ethnicity also indicated a significant association. Publication bias was detected, and the estimated OR including the “missing” studies did not substantially differ from our estimate with adjustment for missing studies (OR 4.15, 95%CI: 2.62-6.54, P < 0.001).
CONCLUSION: Based on the meta-analysis, PD is probably associated with CHD risk independently and significantly.
Core tip: Growing evidence indicated that periodontal disease (PD) might be associated with coronary heart disease (CHD), however, results from the studies were inconsistent. This meta-analysis based on 38 case-control studies indicated that PD increased a 3.79-fold risk of CHD (OR = 3.79, 95%CI: 2.23-6.43, P < 0.001, I2 = 98.59%). The results showed that PD is probably an independent and significant risk factor for CHD.