Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Oct;51(5):705-717.
doi: 10.1111/cdoe.12812. Epub 2022 Nov 15.

Periodontitis and risk of immune-mediated systemic conditions: A systematic review and meta-analysis

Harriet Larvin  1 , Jing Kang  2 , Vishal R Aggarwal  1 , Susan Pavitt  1 , Jianhua Wu  1   3
Affiliations
Free article
Meta-Analysis

Periodontitis and risk of immune-mediated systemic conditions: A systematic review and meta-analysis

Harriet Larvin et al. Community Dent Oral Epidemiol. 2023 Oct.
Free article

Abstract

Introduction: The aim of this review is to examine and quantify the long-term risk of immune-mediated systemic conditions in people with periodontitis compared to people without periodontitis.

Methods: Medline, EMBASE and Cochrane databases were searched up to June 2022 using keywords and MeSH headings. The 'Risk of Bias in Non-Randomised Studies of Interventions' tool was used to assess bias. Cohort studies comparing incident metabolic/autoimmune/inflammatory diseases in periodontitis to healthy controls were included. Meta-analysis and meta-regression quantified risks and showed impact of periodontitis diagnosis type and severity.

Results: The search retrieved 3354 studies; 166 studies were eligible for full-text screening, and 30 studies were included for review. Twenty-seven studies were eligible for meta-analysis. The risks of diabetes, rheumatoid arthritis (RA) and osteoporosis were increased in people with periodontitis compared to without periodontitis (diabetes-relative risk [RR]: 1.22, 95% CI: 1.13-1.33; RA-RR: 1.27, 95% CI: 1.07-1.52; osteoporosis-RR: 1.40, 95% CI: 1.12-1.75). Risk of diabetes showed gradient increase by periodontitis severity (moderate-RR = 1.20, 95% CI = 1.11-1.31; severe-RR = 1.34, 95% CI = 1.10-1.63).

Conclusion: People with moderate-to-severe cases of periodontitis have the highest risk of developing diabetes, while the effect of periodontal severity on risk of other immune-mediated systemic conditions requires further investigation. More homologous evidence is required to form robust conclusions regarding periodontitis-multimorbidity associations.

Keywords: arthritis; cohort studies; diabetes; immune response; periodontitis; systematic review; systemic disease.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Yarnall AJ, Sayer AA, Clegg A, Rockwood K, Parker S, Hindle JV. New horizons in multimorbidity in older adults. Age Ageing. 2017;46(6):882-888.
    1. Wolfe F, Michaud K, Li T, Katz RS. Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia. J Rheumatol. 2010;37(2):305-315.
    1. Mata-Cases M, Franch-Nadal J, Real J, Cedenilla M, Mauricio D. Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study. BMJ Open. 2019;9(10):e031281.
    1. Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Multimorbid disease trajectories for people with periodontitis. J Clin Periodontol. 2021;48:1587-1596.
    1. Smith RL, Soeters MR, Wüst RCI, Houtkooper RH. Metabolic flexibility as an adaptation to energy resources and requirements in health and disease. Endocr Rev. 2018;39(4):489-517.

Publication types

LinkOut - more resources