Periodontal disease and risk of chronic obstructive pulmonary disease: a meta-analysis of observational studies

PLoS One. 2012;7(10):e46508. doi: 10.1371/journal.pone.0046508. Epub 2012 Oct 19.

Abstract

Background: Many epidemiological studies have found a positive association between periodontal disease (PD) and risk of chronic obstructive pulmonary disease (COPD), but this association is varied and even contradictory among studies. We performed a meta-analysis to ascertain the relationship between PD and COPD.

Methods: PubMed and Embase database were searched up to January 10, 2012, for relevant observational studies on the association between PD and risk of COPD. Data from the studies selected were extracted and analyzed independently by two authors. The meta-analysis was performed using the Comprehensive Meta-Analysis software.

Results: Fourteen observational studies (one nested case-control, eight case-control, and five cross-sectional) involving 3,988 COPD patients were yielded. Based on random-effects meta-analysis, a significant association between PD and COPD was identified (odds ratio = 2.08, 95% confidence interval = 1.48-2.91; P<0.001), with sensitivity analysis showing that the result was robust. Subgroups analyses according to study design, ethnicity, assessment of PD/COPD, and adjusted/unadjusted odds ratios also revealed a significant association. Publication bias was detected.

Conclusions: Based on current evidence, PD is a significant and independent risk factor of COPD. However, whether a causal relationships exists remains unclear. Morever, we suggest performing randomized controlled trails to explore whether periodontal interventions are beneficial in regulating COPD pathogenesis and progression.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Case-Control Studies
  • China / epidemiology
  • Cross-Sectional Studies
  • Databases, Bibliographic
  • Disease Progression
  • Europe / epidemiology
  • Female
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Periodontal Diseases / complications
  • Periodontal Diseases / epidemiology*
  • Periodontal Diseases / pathology
  • Publication Bias
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Risk Factors
  • United States / epidemiology

Grant support

This research was supported (in part) by the Intramural Research Program of the Hubei University of Medcine (2011 CZX01), without commercial, or not-for-profit sectors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.