Periodontitis tied to nonalcoholic fatty liver disease
Periodontitis is associated with nonalcoholic fatty liver disease (NAFLD), a recent epidemiological study has shown, adding that the presence of significant liver fibrosis makes this association more robust.
In the first part of the study, where researchers retrieved data from a population-based survey, findings showed that antibodies to the bacterial species Streptococcus noxia and S. oralis were strongly associated with the presence of steatosis even after adjusting for metabolic syndrome (odds ratios, 1.13 and 1.14, respectively).
Moreover, periodontal disease was found to be more severe in patients with advanced NAFLD, with those having high-risk NAFLD fibrosis scores (NFS) presenting with more clinical attachment loss (CAL) than those with low-risk scores.
In a subsequent patient-based study, where 69 NAFLD patients underwent dental examination, researchers found 12 periodontitis cases, resulting in a prevalence rate of 17.4 percent. Diabetes was significantly more frequent in the periodontitis patients (p=0.021).
Periodontitis patients were also significantly more likely to have nonalcoholic steatohepatitis (NASH) of any stage (p=0.0085) and NASH with fibrosis stages F2 to 4 (p=0.005) than those without periodontitis.
Periodontitis was also significantly associated with the stage of liver disease (NASH vs NFLD, p=0.008) and diabetes (p=0.01). Anthropometric and demographic factors such as age, body mass index, waist circumference, blood pressure, ethnicity, sex, and smoking status were unrelated to periodontitis.
“Epidemiological and clinical data reported here independently show a link between periodontitis and NAFLD, and this link is explained by features of metabolic syndrome including diabetes,” said researchers.