Čolak Dejana, Pintar Tadeja, Cmok Kučič Alja, Salobir Jure, Gašpirc Boris, Gašperšič Rok
Oral Health Prev Dent. 2022 Jul 22;20:295-304. doi: 10.3290/j.ohpd.b3240761.
Current discoveries imply a connection between periodontitis and metabolic associated fatty liver disease (MAFLD). This study aimed to determine the prevalence of periodontitis and MAFLD in obese patients with BMI >40, employing the most reliable diagnostic methods, namely liver biopsy, and detailed periodontal examination.
Liver biopsy and periodontal examination were performed in 30 obese patients with BMI BMI >40 undergoing bariatric surgery. Kleiner's classification was used to determine non-alcoholic steatohepatitis (NAS) activity score, non-alcoholic steatohepatitis (NASH) and liver fibrosis. The periodontal condition was classified following the recent AAP/EFP classification. Patients were divided into periodontitis (PG) and non-periodontitis groups (NPG). Data on systemic health parameters were collected from patients' medical records. Descriptive statistics and simple statistical tests were used to determine the differences between the two groups.
The prevalence of NASH in the sample was 43% (13/30), borderline NASH 37% (11/30), while fibrosis stage 1 was most common (72%, [22/30]). Periodontitis prevalence was 67% (20/30), while all non-periodontitis patients (33%; 10/30) exhibited gingivitis. PG and NPG did not differ in NAS or NASH prevalence (p > 0.05). However, the periodontitis group showed higher C-reactive protein levels, while NPG showed higher gamma-glutamyl transpeptidase levels (p < 0.05).
The study results suggest the considerable prevalence of MAFLD, periodontitis and gingivitis in obese patients with BMI >40 undergoing bariatric surgery. Patients with periodontitis had higher CRP levels, while those with gingivitis presented higher gamma-glutamyl transpeptidase levels.
当前的研究发现表明牙周炎与代谢相关脂肪性肝病（MAFLD）之间存在联系。本研究旨在采用最可靠的诊断方法，即肝活检和详细的牙周检查，来确定体重指数（BMI）>40的肥胖患者中牙周炎和MAFLD的患病率。
对30例接受减肥手术、BMI>40的肥胖患者进行了肝活检和牙周检查。采用克莱纳分类法确定非酒精性脂肪性肝炎（NAS）活动评分、非酒精性脂肪性肝炎（NASH）和肝纤维化情况。牙周状况按照美国牙周病学会/欧洲牙周病学会（AAP/EFP）的最新分类进行划分。患者被分为牙周炎（PG）组和非牙周炎组（NPG）。从患者病历中收集全身健康参数数据。使用描述性统计和简单统计检验来确定两组之间的差异。
样本中NASH的患病率为43%（13/30），边缘性NASH为37%（11/30），而纤维化1期最为常见（72%，[22/30]）。牙周炎患病率为67%（20/30），而所有非牙周炎患者（33%；10/30）均表现为牙龈炎。PG组和NPG组在NAS或NASH患病率方面无差异（p>0.05）。然而，牙周炎组的C反应蛋白水平较高，而非牙周炎组的γ-谷氨酰转肽酶水平较高（p<0.05）。
研究结果表明，接受减肥手术、BMI>40的肥胖患者中MAFLD、牙周炎和牙龈炎的患病率相当高。牙周炎患者的CRP水平较高，而牙龈炎患者的γ-谷氨酰转肽酶水平较高。
