title: Periodontal disease and carotid atherosclerosis: A meta-analysis of 17,330 participants.
abstract: OBJECTIVE
  The association between periodontal disease and carotid atherosclerosis has been evaluated primarily in single-center studies, and whether periodontal disease is an independent risk factor of carotid atherosclerosis remains uncertain. This meta-analysis aimed to evaluate the association between periodontal disease and carotid atherosclerosis.
  
  
  METHODS
  We searched PubMed and Embase for relevant observational studies up to February 20, 2015. Two authors independently extracted data from included studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was assessed by the chi-squared test (P<0.1 for statistical significance) and quantified by the I(2) statistic. Data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software.
  
  
  RESULTS
  Fifteen observational studies involving 17,330 participants were included in the meta-analysis. The overall pooled result showed that periodontal disease was associated with carotid atherosclerosis (OR: 1.27, 95% CI: 1.14-1.41; P<0.001) but statistical heterogeneity was substantial (I(2)=78.90%). Subgroup analysis of adjusted smoking and diabetes mellitus showed borderline significance (OR: 1.08; 95% CI: 1.00-1.18; P=0.05). Sensitivity and cumulative analyses both indicated that our results were robust.
  
  
  CONCLUSIONS
  Findings of our meta-analysis indicated that the presence of periodontal disease was associated with carotid atherosclerosis; however, further large-scale, well-conducted clinical studies are needed to explore the precise risk of developing carotid atherosclerosis in patients with periodontal disease.
authors.affiliation: Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
authors.forename: Xian-Tao
authors.initials: XT
authors.lastname: Zeng
authors.affiliation: Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Leng
authors.affiliation: Centre Medical, Central, Hong Kong Island, Hong Kong.
authors.forename: Yat-Yin
authors.initials: YY
authors.lastname: Lam
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Yan
authors.affiliation: Department of Nursing, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Wei
authors.affiliation: Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Weng
authors.affiliation: Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: jswkwong@hotmail.com.
authors.forename: Joey S W
authors.initials: JS
authors.lastname: Kwong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002340:Carotid Artery Diseases / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D010510:Periodontal Diseases / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Carotid artery diseases; Carotid atherosclerosis; Meta-analysis; Periodontal disease