The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study

Abstract

Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Design: This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957). Material & Methods: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension. Results: The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006–1.591; p = 0.045) was independently associated with PAOD. Conclusion: In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.

Risk of Peripheral Arterial Occlusive Disease with Periodontitis and Dental Scaling: A Nationwide Population-Based Cohort Study

“…The association between PD and the risk of PAOD has been discussed since 1998. Two recent systematic reviews and a prospective population-based cross-sectional cohort study have investigated this association [ 20 , 21 , 22 ]. Their results indicated that PD could increase the risk of PAOD.…”

Now Is the Time to Bring a Common but Unpopular Noncommunicable Disease into Focus: Peripheral Arterial Disease Takes Limbs and Lives, but It Must Also Touch Our Hearts!

“…Trenner et al used DRG reimbursement data derived from the German statistical office to determine how practice patterns differed between federal states in Germany [ 9 ]. Closely related to the latter publication, Jacobi et al and Keller et al used data from a large epidemiological cohort study and administrative data to determine the association between periodontitis and diabetes, respectively, and PAD [ 10 , 11 ]. There is an increasing interest in the modifying role of chronic inflammation in cardiovascular disease development while both diabetes and periodontitis may serve as good examples for research projects.…”