Association Between Periodontitis and COPD : A Large Multi‐Database Cross‐Sectional Study

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ABSTRACT Background This study investigated the association between periodontitis, a chronic bacteria‐initiated inflammatory disease, and chronic obstructive pulmonary disease (COPD). Methods Based on the US National Health and Nutrition Examination Survey (NHANES) 2009–2014 data including 3626 adults aged 30–79, we analyzed the bidirectional association using multivariable binary logistic regression for periodontitis with COPD and ordinal regression for COPD with periodontitis severity. Besides, we compared systemic inflammation markers—including neutrophil‐to‐lymphocyte (NLR), platelet‐to‐lymphocyte (PLR), and monocyte‐to‐lymphocyte ratios (MLR), alongside the systemic immune‐inflammation (SII) and aggregate systemic inflammation indices (AISI)—among healthy control, periodontitis, and COPD groups using local clinical data from 210 subjects at the second affiliated hospital of Nanchang University. Results After multivariable adjustment, individuals with mild–moderate and severe periodontitis had 44% (OR = 1.44, 95% CI: 1.10–1.88) and 52% (OR = 1.52, 95% CI: 1.01–2.26) higher risks of COPD, respectively ( p for trend = 0.007). Conversely, COPD was an independent risk factor for periodontitis severity (OR = 1.44, 95% CI: 1.14–1.82). Local data demonstrated that compared to healthy controls, AISI, SII, NLR, and MLR were significantly elevated in both periodontitis and COPD groups, while no significant difference was found between the two disease groups. Conclusions Periodontitis and COPD are both characterized by a similar systemic inflammatory profile and demonstrate a robust, independent, bidirectional association.