title: Increased prevalence of cardiovascular and autoimmune diseases in periodontitis patients: a cross-sectional study.
abstract: BACKGROUND
  Associations between periodontitis and cardiovascular and autoimmune diseases are most often assessed in patients with a particular cardiovascular or autoimmune disease. To prevent selection bias, this study assesses the existence of associations between periodontitis and cardiovascular and autoimmune diseases in patients attending a dental or periodontal clinic.
  
  
  METHODS
  Data were collected from 1,276 randomly selected dental records from patients attending a dental (n = 588) or periodontal (n = 688) clinic. Data on the prevalence of cardiovascular and autoimmune diseases were obtained from a validated health questionnaire. Data on the presence of periodontitis were taken from patients' dental records.
  
  
  RESULTS
  In uncontrolled analyses, the prevalence of hypertension, diabetes mellitus (DM), and rheumatoid arthritis (RA) is significantly increased in patients with periodontitis. Controlled for confounding, periodontitis was associated with DM, with an odds ratio of 4 (1.03 to 15.3), in the dental clinic. DM was not associated with periodontitis in periodontal clinics. Hypertension does not seem to be associated with periodontitis when controlling for confounders. Periodontitis may be associated with RA in both clinic types.
  
  
  CONCLUSIONS
  The increased prevalence of cardiovascular and autoimmune diseases among patients with periodontitis attending dental or periodontal clinics may, at least in part, be influenced by confounding. However, the increased prevalence of DM and RA in patients with periodontitis could not be explained by confounding.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Nesse
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: Frank
authors.initials: F
authors.lastname: Abbas
authors.forename: Fred K L
authors.initials: FK
authors.lastname: Spijkervet
authors.forename: Astrid
authors.initials: A
authors.lastname: Stijger
authors.forename: Jan A H
authors.initials: JA
authors.lastname: Tromp
authors.forename: Johan L
authors.initials: JL
authors.lastname: van Dijk
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
mesh_terms: D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003792:Dental Records / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007037:Hypothyroidism / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D010512:Periodontal Index; D010518:Periodontitis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D011795:Surveys and Questionnaires