Obesity as a shared risk factor in periodontitis and rheumatoid arthritis: Systematic review and meta-analysis

Aims: Studies have investigated the interrelationship between periodontitis (PD) and rheumatoid arthritis (RA). However, obesity, a risk factor common between both conditions requires further investigation. Therefore, the objective of this study was to pool evidence on whether concurrent RA and PD (RAPD) are associated with high Body Mass Index (BMI) compared to non-RAPD individuals. Methods: Systematic review conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with the protocol registered with the International Prospective Register of Systematic Reviews. Embase, Medline, Web of Science and the Cochrane Library were accessed for relevant literature. The Newcastle-Ottawa scale was used to assess risk of bias among each study. Meta-analysis was performed using Revman statistical software. The effect size was measured using mean difference with 95% confidence intervals and a p-value of 0.05. Results: The search identified 770 articles. Following screening of title with abstracts and full text assessment, nine studies, involving 86,137 participants were included. Seven studies reported low to moderate risk of bias. In meta-analysis BMI was higher in people with RAPD than non-RAPD (MD = 0.56; Z = 2.06; p = 0.04). Conclusion: The correlation between high BMI and RAPD underscores a potential interplay between periodontal health and inflammatory diseases like obesity and RA. Thus, observational studies are warranted.