Meta-Analysis
Copyright ©2013 Baishideng. All rights reserved.
World J Meta-Anal. May 26, 2013; 1(1): 47-56
Published online May 26, 2013. doi: 10.13105/wjma.v1.i1.47
Periodontal disease is associated with increased coronary heart disease risk: A meta-analysis based on 38 case-control studies
Wei-Dong Leng, Xian-Tao Zeng, Yong-Ji Chen, Zhong-Qun Zhan, Yong Yang
Wei-Dong Leng, Xian-Tao Zeng, Yong-Ji Chen, Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Zhong-Qun Zhan, Yong Yang, Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Author contributions: Leng WD and Zeng XT contributed equally to this work; Zeng XT, Chen YJ, Zhan ZQ and Yang Y performed the literature search, study selection and data extraction; Leng WD, Zeng XT and Zhan ZQ analyzed the results; Zeng XT and Chen YJ did the statistical analysis; Zeng XT and Zhan ZQ drafted the manuscript; all authors provided input into the development of the manuscript; all authors have approved the final manuscript.
Supported by The Foundation of Education and Science Planning Project of Hubei Province (in part), No.2012A050; and the Intramural Research Program of Hubei University of Medicine, No. 2011CZX01.
Correspondence to: Wei-Dong Leng, Professor, Department of Stomatology, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, China. lengtaihe@163.com
Telephone: +86-719-8801427 Fax: +86-719-8883809
Received: March 5, 2013
Revised: April 4, 2013
Accepted: May 7, 2013
Published online: May 26, 2013
Processing time: 79 Days and 21.8 Hours
Abstract

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.

Keywords: Periodontal disease; Coronary heart disease; Case-control study; Risk factor; Meta-analysis

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.