牙周炎与日本成年人非酒精性脂肪性肝病纤维化进展的关系。
Association between periodontitis and fibrotic progression of non-alcoholic fatty liver among Japanese adults.
机构信息
Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
出版信息
J Clin Periodontol. 2021 Mar;48(3):368-377. doi: 10.1111/jcpe.13415. Epub 2021 Jan 19.
AIM
Non-alcoholic fatty liver (NAFL) is known to develop into liver fibrosis, which increases the risk of liver cirrhosis and liver cancer. The association between periodontal condition and fibrotic progression of NAFL is unclear. This study aimed to clarify this longitudinal association.
MATERIALS AND METHODS
Among 4812 participants aged 35-64 years undergoing annual health check-ups between 2003 and 2004, and follow-up 5 years later, 392 participants were diagnosed with NAFL. After excluding participants with liver fibrosis at baseline, 341 participants were followed up for 5 years. NAFL disease fibrosis score of ≥-1.455 was used to evaluate the probability of the presence of liver fibrosis.
RESULTS
During the follow-up period, 10.6% of participants progressed to liver fibrosis. A higher clinical attachment level (CAL) tended to be associated with the incidence of liver fibrosis in the logistic regression analysis (odds ratio [OR] 1.82, 95% confidence interval [CI], 0.94-3.49, p = .074). The stratified analysis by obesity revealed a significant association with higher CAL in obese participants (OR 2.87, 95% CI, 1.23-6.69, p = .015), but not in non-obese participants.
CONCLUSION
Higher CAL was associated with an increased probability of liver fibrosis in obese adults with NAFL.
目的
非酒精性脂肪性肝病（NAFL）已知可发展为肝纤维化，从而增加肝硬化和肝癌的风险。牙周状况与 NAFL 纤维化进展之间的关联尚不清楚。本研究旨在阐明这种纵向关联。
材料和方法
在 2003 年至 2004 年间接受年度健康检查且年龄在 35-64 岁的 4812 名参与者中，随访 5 年后，有 392 名参与者被诊断为 NAFL。在排除基线时有肝纤维化的参与者后，有 341 名参与者被随访 5 年。NAFL 疾病纤维化评分≥-1.455 用于评估存在肝纤维化的概率。
结果
在随访期间，有 10.6%的参与者进展为肝纤维化。在逻辑回归分析中，较高的临床附着水平（CAL）与肝纤维化的发生率呈正相关（优势比[OR] 1.82，95%置信区间[CI]，0.94-3.49，p=0.074）。按肥胖分层的分析显示，CAL 较高与肥胖参与者中肝纤维化的发生具有显著相关性（OR 2.87，95%CI，1.23-6.69，p=0.015），但在非肥胖参与者中无相关性。
结论
较高的 CAL 与肥胖的 NAFL 成年人肝纤维化的概率增加相关。
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