title: Periodontitis may increase the risk of peripheral arterial disease.
abstract: OBJECTIVE
  The aim of this case control study was to evaluate whether periodontitis was associated with peripheral arterial disease (PAD).
  
  
  METHODS
  Twenty-five patients diagnosed with aorto-iliac and/or femoro-popliteal occlusive disease and thirty-two generally healthy control subjects were enrolled in this study. Polymerase chain reaction (PCR) was used to identify Porphyromonas gingivalis, Treponema denticola, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Cytomegalovirus (CMV), Chlamydia pneumoniae, and Helicobacter pylori in tissue specimens taken from the anastomotic site of distal bypasses. Periodontal status was evaluated; serum IgG titres against the four listed bacteria were measured.
  
  
  RESULTS
  Periodontopathic bacteria were detected in 13/25 (52%) atherosclerotic specimens. CMV or C. pneumoniae was detected in 1/25 (4%) specimens; H. pylori was not detected from any of these specimens. Fontaine grade III or IV patients showed higher detection frequency of P. gingivalis than Fontaine grade II patients (57.1% vs 22.2%, P=0.09). After adjusting for age, gender, diabetes and smoking, periodontitis increased 5-fold the risk of having PAD (OR 5.45). There were preliminary indications that periodontitis was associated with increased serum IL-6 and TNF-alpha concentrations.
  
  
  CONCLUSIONS
  This study suggests that periodontitis may be associated with an increased risk of PAD. This association could result from the increased concentration of serum inflammatory cytokines in those with periodontitis.
authors.affiliation: Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Yushima, Tokyo, Japan. evelyn.peri@tmd.ac.jp
authors.forename: Y-W
authors.initials: YW
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Umeda
authors.forename: T
authors.initials: T
authors.lastname: Nagasawa
authors.forename: Y
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Iwai
authors.forename: Y
authors.initials: Y
authors.lastname: Izumi
authors.forename: I
authors.initials: I
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001018:Aortic Diseases / Q000209:etiology* / Q000382:microbiology / Q000601:surgery / Q000821:virology; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000382:microbiology / Q000601:surgery / Q000821:virology; D016022:Case-Control Studies; D005260:Female; D005263:Femoral Artery / Q000382:microbiology / Q000601:surgery / Q000821:virology; D006801:Humans; D007083:Iliac Artery / Q000382:microbiology / Q000601:surgery / Q000821:virology; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000382:microbiology / Q000601:surgery / Q000821:virology; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000382:microbiology / Q000601:surgery / Q000821:virology; D011150:Popliteal Artery / Q000382:microbiology / Q000601:surgery / Q000821:virology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014656:Vascular Surgical Procedures
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha