Periodontitis and coronary artery calcification: the Atherosclerosis Risk in Communities (ARIC) study.
BACKGROUND
Periodontitis has been linked to coronary heart disease (CHD) risk, possibly through providing a systemic inflammatory burden. Few studies have evaluated periodontitis and subclinical measures of atherosclerosis. Coronary artery calcification (CAC) is an emerging marker for atherosclerosis, and past studies suggest that it predicts incident CHD in asymptomatic populations.


METHODS
In 1996-1998, dental examinations were performed on 6,931 participants in the Atherosclerosis Risk in Communities (ARIC) cohort. Extent of periodontitis was measured by the percent of sites with attachment level (AL) > or = 3 mm. In 1999-2000, CAC was measured by cardiac gated mechanical or helical computed tomography in 269 dental examinees and edentulous subjects from the Minnesota and North Carolina field centers of ARIC who were free of clinically recognized CHD. A traditional Agatston score for CAC was calculated.


RESULTS
Compared to subjects with no or mild periodontitis (<10% of sites with AL > or = 3 mm), subjects with moderate or severe periodontitis (> or = 10% of sites with AL > or = 3 mm) were more likely to have CAC > or = 100, but this difference was not statistically significant (odds ratio [OR]: 1.78; 95% confidence interval [CI]: 0.65 to 4.86). This association was partially but not completely attenuated when adjusted for demographic factors and traditional CHD risk factors (OR: 1.51; 95% CI: 0.54 to 4.23).


CONCLUSIONS
These results suggest that periodontitis is not strongly associated with CAC. This study offers some reference for the magnitude of the association between CAC and periodontitis and information regarding the minimal power necessary for future studies.
Nakib
Sarah A
SA
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
Pankow
James S
JS
Beck
James D
JD
Offenbacher
Steven
S
Evans
Gregory W
GW
Desvarieux
Moise
M
Folsom
Aaron R
AR
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000209:etiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications*; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D014057:Tomography, X-Ray Computed / Q000379:methods