Periodontitis Is Related to Exercise Capacity: Two Cross-sectional Studies

Area of Science:

• Cardiology
• Periodontology
• Exercise Physiology

Background:

• Periodontitis is increasingly recognized for its systemic implications, potentially influencing cardiometabolic health.
• Limited evidence exists on the direct association between periodontitis and cardiorespiratory fitness.

Purpose of the Study:

• To investigate the association between clinically assessed periodontitis and cardiopulmonary exercise testing (CPET) parameters.
• To explore potential mechanisms linking oral health to cardiovascular function.

Main Methods:

• Analysis of data from two independent population-based cross-sectional studies (SHIP-1 and SHIP-Trend-0).
• Clinical periodontal examination including pocket probing depth (PPD) and clinical attachment levels, alongside tooth count.
• Cardiopulmonary exercise testing (CPET) using symptom-limited bicycle ergometry.
• Confounder-adjusted multivariable linear regression to assess associations between periodontitis and CPET parameters.

Main Results:

• Mean PPD, clinical attachment levels, and tooth count were consistently associated with peak oxygen uptake (peakVO2) and exercise duration across both studies.
• Significant associations were observed with oxygen uptake at anaerobic threshold (VO2@AT) and the VÉ/VCO2 slope.
• Older individuals with more severe periodontitis showed lower peakVO2.
• Associations were primarily linked to mean PPD, reflecting current disease severity, particularly in never-smokers.

Conclusions:

• Mean PPD, a measure of current gum disease severity, is consistently associated with cardiorespiratory fitness in the general population.
• This association may represent a biologically plausible link between periodontitis and cardiometabolic diseases.
• Further longitudinal studies are warranted to confirm these findings and elucidate the underlying mechanisms.