Department of Preventive Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
Department of Periodontology, College of Dentistry, Sanaa University, Sanaa, Yemen.
Clin Oral Investig. 2018 Dec;22(9):2965-2974. doi: 10.1007/s00784-018-2726-1. Epub 2018 Oct 24.
Many animal and human studies have shown associations between periodontitis and non-alcoholic fatty liver disease (NAFLD). Hence, the present systematic review sought to investigate such a potential association.
PubMed/Medline, Scopus, Embase, and Web of Science databases were thoroughly searched to identify all relevant studies. The eligibility criteria were all observational (cross-sectional studies, case-control, cohort studies, and case reports) and interventional studies that assessed the relationship between periodontitis and NAFLD in humans. Due to remarkable heterogeneity and inconsistency among the included studies, no statistical analyses were conducted.
A total of 12 studies comprising 53,384 patients were included in the present systematic review. The sample size in the individual studies ranged from 52 to 24,470 patients. All studies except one found significant associations between clinical and/or microbial periodontal parameters and NAFLD. Eight studies found significant associations between clinical periodontal parameters and NAFLD. Four microbial studies found a significant association between periodontal pathogens, especially Porphyromonas gingivalis and NAFLD development and progression.
The available evidence suggests that periodontitis may be a risk factor for development and progression of NAFLD. However, due to limited number of prospective cohort studies included in this review along with the substantial heterogeneity among the included studies, further well-designed prospective cohort studies are highly warranted.
Given the potential association between periodontitis and NAFLD, it can be assumed that healthy periodontium may be essential for liver health.
许多动物和人体研究表明，牙周炎与非酒精性脂肪性肝病（NAFLD）之间存在关联。因此，本系统评价旨在探讨这种潜在的关联。
彻底检索了 PubMed/Medline、Scopus、Embase 和 Web of Science 数据库，以确定所有相关研究。纳入标准为所有观察性研究（横断面研究、病例对照研究、队列研究和病例报告）和评估牙周炎与人类 NAFLD 之间关系的干预性研究。由于纳入研究之间存在显著的异质性和不一致性，因此未进行统计分析。
本系统评价共纳入了 12 项研究，共计 53384 名患者。各研究的样本量范围为 52 至 24470 名患者。除一项研究外，所有研究均发现临床和/或微生物牙周参数与 NAFLD 之间存在显著关联。八项研究发现临床牙周参数与 NAFLD 之间存在显著关联。四项微生物研究发现牙周病原体（尤其是牙龈卟啉单胞菌）与 NAFLD 的发生和进展之间存在显著关联。
现有证据表明，牙周炎可能是 NAFLD 发生和进展的一个危险因素。然而，由于本综述纳入的前瞻性队列研究数量有限，且纳入研究之间存在很大的异质性，因此需要进一步进行设计良好的前瞻性队列研究。
鉴于牙周炎和 NAFLD 之间存在潜在的关联，可以假设健康的牙周组织可能对肝脏健康至关重要。
