The relationship between periodontal disease and non-communicable diseases associated with endothelial dysfunction

Objectives: Periodontal diseases (PD) have been associated with risk of a number of non-communicable diseases and in particular those associated with endothelial dysfunction such as cardiovascular disease, chronic kidney disease (CKD) and cerebrovascular disease. Given our recent finding of the association of Calcium Channel Blocker drugs (CCBs) with Periodontal Disease, the aims of this study were to investigate the association of periodontal disease with these conditions in the NHANES 2011-12 dataset and secondly to determine if CCBs might act as a confounder for this association.
Methods: We performed a retrospective analysis of the 2011-2012 NHANES (National Health and Nutritional Examination Survey) dataset. We tested the relationship of moderate to severe periodontitis (Page and Eke (2012) against CKD (stages 3-5), Ischaemic heart disease (IHD) and cerebrovascular disease (CVD).
Results: 3313 participants of ages 30 – 80 ( mean 52 ± 14.2) were identified with full periodontal charts. 1625 of these had moderate –severe periodontitis. 200 had CKD, 103 had IHD and 93 had CVD. In univariate analyses ( Fishers Exact test) periodontitis was associated with CKD (P <0.001, OR: 1.83, 1.36 – 2.46 95% CI); IHD ( P<0.001, OR 2.574, 1.69 – 3.9) and CVD ( P < 0.001, OR 3.073 1.92 – 4.91). When subjects taking CCBs were excluded from the analyses, the associations seen persisted although the odds ratios were slightly reduced (CKD 1.53; IHD 2.38; CVD 2.8).
Conclusions: The results support the findings of studies of other datasets of the association of moderate to severe PD with presence of CKD, IHD and CVD. Further multivariate analyses are required to investigate the effects of the many potential confounders in this data, and particularly to investigate more deeply if CCBs may act as a confounding factor.