Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Clin Periodontol. 2017 Nov;44(11):1077-1087. doi: 10.1111/jcpe.12800. Epub 2017 Sep 22.
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.
To investigate epidemiologic associations between periodontitis and the incidence of NAFLD among 2,623 participants of the Study of Health in Pomerania.
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.
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.
History of periodontitis may be a risk factor for NAFLD.
非酒精性脂肪性肝病（NAFLD）影响 20%-30%的成年人，肥胖和胰岛素抵抗等危险因素可能通过慢性低度炎症起作用。由于牙周炎引发低度炎症，我们假设它可能导致 NAFLD 的发生。
在波罗的海健康研究的 2623 名参与者中，调查牙周炎与 NAFLD 发生率之间的流行病学关联。
基线时的牙周炎定义为（i）临床附着丧失（CAL）≥3mm的位点百分比；（ii）探诊深度（PD）≥4mm的位点百分比。新发 NAFLD 定义为与肾脏相比，肝脏超声回声显著增加，膈膜不清晰或门静脉回声壁不可见。
中位随访 7.7 年后，605 例新发 NAFLD 病例的发生率为每 1000 人年 32.5 例。与 CAL≥3mm 的参与者相比，受影响的位点百分比<30%的参与者中，NAFLD 的发病率略有升高，受影响的位点百分比≥30%的参与者中，NAFLD 的发病率中度升高（多变量调整后的发病率比=1.28，95%CI，0.84，1.95 和 1.60，95%CI，1.05-2.43）。对于 PD，未观察到类似的剂量反应关系。
牙周炎病史可能是 NAFLD 的一个危险因素。
