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. 2021 Dec 7;21(1):621.
doi: 10.1186/s12903-021-01951-z.

Risk of coronary heart disease in patients with periodontitis among the middled-aged and elderly in China: a cohort study

Kaikai Gao  1   2   3 , Zhiyuan Wu  1 , Yue Liu  1 , Lixin Tao  1   4 , Yanxia Luo  1   4 , Xinghua Yang  1   4 , Jingbo Zhang  5 , Xiuhua Guo  6   7   8   9 , Songlin Wang  10   11
Affiliations

Risk of coronary heart disease in patients with periodontitis among the middled-aged and elderly in China: a cohort study

Kaikai Gao et al. BMC Oral Health. .

Abstract

Background: Convincing evidence of the periodontitis as a risk factor for coronary heart disease (CHD) is lacking due to shared risk factors, and no cohort study has investigated the association between CHD and periodontitis in Chinese populations.

Methods: This study used a prospective cohort study design. The analysis included 4591 participants aged 40 years and older (3146 men and 1445 women). The association between CHD and periodontitis was estimated using relative risk (RR) calculated using modified Poisson regression. Multiple mediation analysis was used to differentiate the relative effects (RE) from different risk factors on the effect of periodontitis on CHD.

Results: In the analysis using the imputed dataset and fully adjusted model, participants with periodontitis at baseline had 37% increased risk of CHD overall compared to those without periodontitis at baseline (RR 1.37; 95% CI 0.96-1.95). Most of the association can be explained by age, sex, history of diabetes, history of hypertension, uric acid and education (RE 0.76; 95% CI 0.41-1.02).

Conclusion: Periodontitis was weakly associated with an increased risk of CHD among the middled-aged and elderly in China. Further studies are required to identify more mediators and elucidate the mechanisms of how periodontitis increases the risk of CHD.

Keywords: Cohort study; Coronary heart disease; Oral health; Periodontitis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study population
Fig. 2
Fig. 2
Estimated relative effects (RE) on the effect of periodontitis on CHD from the multiple mediation analysis. RE is defined as the ratio of the indirect effect of different risk factors on the total effect of periodontitis on CHD. DE represents the ratio of the direct effect of periodontitis on the total effect of periodontitis on CHD. Abbreviations: DE direct effect, UA uric acid
Fig. 3
Fig. 3
The marginal effect of the age, sex, history of diabetes and history of hypertension in additive regression trees (MART) model, and the distribution of the variables in participants with and without periodontitis at baseline
See this image and copyright information in PMC

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