Chronic periodontitis and the risk of erectile dysfunction: a systematic review and meta-analysis

The objective of this study is to evaluate the association between chronic periodontitis (CP) and the risk of erectile dysfunction (ED). Electronic search using PubMed, Embase and the Cochrane Library was carried out for observational studies, longitudinal, cohort, case-control and epidemiological studies on humans, published up to December 2015. Manual searches were also performed. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to estimate the association between CP and the risk of ED. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale. Four case-control studies and one cross-sectional studies involving 213, 006 participants were included. Based on the random-effects model, analyses of all studies showed that CP was associated with an increased risk of ED (OR=2.28, 95% CI: 1.50-3.48). There was heterogeneity among the studies (P<0.001, I²=97.8%). Estimates of total effects were generally consistent with the sensitivity and subgroup analyses. In conclusion, our meta-analysis suggested that there was a significant association between CP and the risk of ED. Further epidemiological studies are needed to better estimate the key risk factors for periodontitis and their interaction effects.