title: Periodontitis is associated with the risk of subclinical atherosclerosis and peripheral arterial disease in Korean adults.
abstract: We aimed to evaluate the association of periodontitis with the development of early atherosclerotic vascular disease in Korean adults.
  
  
  
  In this cross-sectional study, a total of 1343 adults aged over 40 years were recruited from a community-based cohort of Yangpyeong county, Korea, during the period 2010-2014. Only dentate individuals were included in the study. Subclinical atherosclerosis (SA) was defined as carotid intima-media thickness (cIMT)≥0.754 mm, as assessed bilaterally by B-mode ultrasound. Peripheral arterial disease (PAD) was defined as ankle-brachial index (ABI)≤1.0, as measured by Doppler. History of periodontitis was assessed by measuring the radiographic alveolar bone loss (RABL) on a digital dental panorama and was classified into three groups: normal, moderate and severe periodontitis (≥2 non-adjacent interproximal sites with RABL≥4 mm and 6 mm, respectively). The associations of periodontitis with SA and PAD were evaluated by multivariable logistic regression analysis and analysis of covariance, adjusted for age, sex, education level, tooth loss, smoking, drinking, exercise, obesity, triglycerides, HDL, LDL, hs-CRP, diabetes and hypertension. Stratified analyses were performed to identify specific risk groups.
  
  
  
  After controlling for confounders, severe periodontitis was associated with SA [adjusted odds ratio (aOR) = 1.55; 95% confidence interval (CI): 1.07-2.24] and PAD (aOR = 2.03; 95% CI: 1.05-3.93). These associations were highlighted in never-smokers. For increasing severity of periodontitis, the adjusted mean cIMT increased (p = 0.011) while that of ABI decreased (p = 0.033).
  
  
  
  Our data showed that periodontitis is a substantially important risk factor for atherosclerotic vascular disease among Korean adults.
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Yoo-Been
authors.initials: YB
authors.lastname: Ahn
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Myung-Seop
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea; Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Dong-Hun
authors.initials: DH
authors.lastname: Han
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Munkhzaya
authors.initials: M
authors.lastname: Sukhbaatar
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Mi-Sun
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea.
authors.forename: Hye-Sun
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea; Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea. Electronic address: hyundkim@snu.ac.kr.
authors.forename: Hyun-Duck
authors.initials: HD
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000208:ethnology*; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000208:ethnology*; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000208:ethnology*; D012044:Regression Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
keywords: Ankle-brachial index; Epidemiology; Intima-media thickness; Periodontitis; Peripheral arterial disease; Subclinical atherosclerosis