The risk of periodontitis for peripheral vascular disease: a systematic review

Periodontitis is one of the risk factors associated with peripheral artery disease. This meta-analysis evaluates how periodontitis contributes to the pathogenesis and progression of peripheral artery disease. We systematically searched electronic databases Ovid Medline, Embase, Cochrane Library and Pubmed. Grey literature was also searched via Google Scholar. All studies evaluating the relationship between the incidence of periodontitis and peripheral artery disease were included. Subgroup analyses of carotid artery disease and lower extremity arterial disease were also conducted. Odds ratios (OR) and 95% confidence intervals (CI) were pooled and analyzed. The I² statistic was used to evaluate heterogeneity. Within a total of 25 studies, including 22,090 participants based on eligibility criteria, the incidence of peripheral artery disease was significantly higher among those with periodontitis (OR: 1.60, 95% CI 1.41-1.82, P < 0.001, I² = 80.5%). In subgroup analysis, periodontitis was still a risk for lower extremity arterial disease (OR: 3.00, 95% CI 2.23-4.04, P < 0.001, I² = 0%) and carotid artery disease (OR: 1.39, 95% CI 1.24-1.56, P < 0.001, I² = 79.4%). Periodontitis is significantly associated with the incidence of lower extremity arterial disease and carotid artery disease.