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. 2017 Nov;44(11):1077-1087.
doi: 10.1111/jcpe.12800. Epub 2017 Sep 22.

Periodontitis and Non-alcoholic Fatty Liver Disease, a population-based cohort investigation in the Study of Health in Pomerania

Aderonke A Akinkugbe  1 , Gary D Slade  2 , A Sidney Barritt  3 , Stephen R Cole  1 , Steven Offenbacher  4 , Astrid Petersmann  5 , Thomas Kocher  6 , Markus M Lerch  7 , Julia Mayerle  8 , Henry Völzke  9 , Gerardo Heiss  1 , Birte Holtfreter  6
Affiliations

Periodontitis and Non-alcoholic Fatty Liver Disease, a population-based cohort investigation in the Study of Health in Pomerania

Aderonke A Akinkugbe et al. J Clin Periodontol. 2017 Nov.

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) affects 20%-30% of adults with risk factors like obesity and insulin resistance putatively acting through chronic low-grade inflammation. Because periodontitis elicits low-grade inflammation, we hypothesized that it could contribute to NAFLD occurrence.

Objective: To investigate epidemiologic associations between periodontitis and the incidence of NAFLD among 2,623 participants of the Study of Health in Pomerania.

Methods: Periodontitis at baseline was defined as the percentage of sites (0%, <30%, ≥30%) with (i) clinical attachment level (CAL) ≥3 mm; (ii) probing pocket depth (PD) ≥4 mm. Incident NAFLD was defined as a significant increase in liver echogenicity on ultrasound relative to the kidneys, with the diaphragm indistinct or the echogenic walls of the portal veins invisible.

Results: After a median 7.7 years of follow-up, 605 incident NAFLD cases occurred at a rate of 32.5 cases per 1,000 person-years. Relative to participants without CAL ≥3 mm, NAFLD incidence was elevated slightly in participants with <30% of sites affected and moderately in participants with ≥30% of sites affected (multivariable-adjusted incidence rate ratio = 1.28, 95% CI, 0.84, 1.95 and 1.60, 95% CI, 1.05-2.43), respectively. A similar dose-response relationship was not observed for PD.

Conclusion: History of periodontitis may be a risk factor for NAFLD.

Keywords: epidemiologic; hepatic steatosis; oral-systemic disease; periodontal disease; population health; prospective cohort.

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Conflict of interest statement

Conflicts of interest

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

Figure 1
Figure 1
Panel A, Confounding and censoring adjusted cumulative risk curves of NAFLD occurrence according to the proportion of periodontal sites with clinical attachment level of ≥3mm (edentulous, 0%, >0%) at baseline. Panel B, Confounding and censoring adjusted cumulative risk curves of NAFLD occurrence according to the proportion of periodontal sites with probing pocket depth of ≥4mm (edentulous, 0%, >0%) at baseline.
Figure 1
Figure 1
Panel A, Confounding and censoring adjusted cumulative risk curves of NAFLD occurrence according to the proportion of periodontal sites with clinical attachment level of ≥3mm (edentulous, 0%, >0%) at baseline. Panel B, Confounding and censoring adjusted cumulative risk curves of NAFLD occurrence according to the proportion of periodontal sites with probing pocket depth of ≥4mm (edentulous, 0%, >0%) at baseline.
See this image and copyright information in PMC

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