Association between periodontitis and hyperlipidaemia: A systematic review and meta-analysis

To date, it has been reported that periodontitis (PD) may be associated with hyperlipidaemia in clinical practice. However, data on this issue are inconsistent and controversial. The purpose of this meta-analysis was to identify the association between PD and hyperlipidaemia. Here, 21 case-control and eight cross-sectional studies on PD and hyperlipidaemia were included in the random-effects meta-analysis, involving 2060 patients with PD and 2776 healthy controls (HC). Meta-analysis showed that serum triglyceride (TG) and total cholesterol (TC) levels in the PD group were significantly higher than those in the HC group [TG, weighted mean difference (WMD) = 19.4 mg/dL, 95% confidence interval (CI) 13.3-25.5 mg/dL,P = .000; TC, WMD = 15.4 mg/dL, 95%CI 10.2-20.6 mg/dL,P = .000]. Subgroup analysis stratified by study design validated that PD was associated with higher serum TG and TC levels. In addition, compared with the HC group, serum low-density lipoprotein (LDL) in patients with PD showed a markedly higher level (WMD = 11.7 mg/dL, 95% CI 8.3-15.0 mg/dL,P = .000), whereas serum high-density lipoprotein (HDL) in PD group exhibited a significantly lower level (WMD = -4.5 mg/dL, 95%CI -6.4 - -2.7 mg/dL,P = .000). Finally, no significant publication bias was observed and sensitivity analysis also confirmed the stability of our meta-analyses. In conclusion, the accumulated evidence suggests that PD is indeed associated with hyperlipidaemia in humans. More interventions for lowering lipids or increasing HDL may benefit the patients with PD, which need be further investigated in prospective clinical trials.