Cross-sectional analysis of periodontitis and peripheral artery disease association: Results from National Health and Nutrition Examination Survey 1999 to 2004.

Periodontitis affected 16.7% of the study cohort and PAD prevalence reached 4.4% in the NHANES 1999-2004 sample.

• Total cohort consisted of 4133 individuals with a mean ± standard deviation age of 56.8 ± 12.1 years
• Female proportion was 46.8% of the cohort
• Periodontal disease affected 16.7% of participants (n=690)
• PAD prevalence reached 4.4% (n=182)
• Clinical classifications applied CDC/AAP diagnostic thresholds; PAD defined by ankle-brachial index below 0.9 in any leg

PAD frequency was elevated in periodontitis subjects compared to non-periodontitis controls.

• PAD frequency was 8.1% (56/690) in periodontitis subjects
• PAD frequency was 3.7% (126/3443) in non-periodontitis controls
• This represents approximately a 2.2-fold higher crude prevalence of PAD among those with periodontitis

After comprehensive covariate adjustment, periodontitis maintained an independent association with PAD.

• Multivariable logistic regression was used to quantify the relationship
• Adjusted OR = 1.49 (95% CI: 1.04–2.13; P-value = .03)
• The association remained statistically significant following adjustment for covariates

Stratified subgroup analyses indicated absence of significant interaction effects across subgroups.

• Stratified subgroup assessments were performed for robustness verification
• All interaction P-values were >0.05
• No significant interaction effects were identified in any subgroup examined

The study design was cross-sectional, precluding causal inference, and prospective investigations were deemed necessary.

• Data were drawn from NHANES 1999 to 2004 datasets
• The authors note that 'prospective investigations remain imperative to determine causality'
• The nationally representative sample supports generalizability to the U.S. adult population