Ram Doron, Wilensky Asaf, Zur Dorit, Almoznino Galit
In Partial Fulfillment DMD Thesis, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.
Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Periodontology, Hadassah Medical Center, Jerusalem 91120, Israel.
Metabolites. 2022 Dec 2;12(12):1212. doi: 10.3390/metabo12121212.
This study aimed to analyze the associations of nonalcoholic fatty liver disease (NAFLD) with dental parameters, while controlling for socio-demographics, health-related habits, and each of the metabolic syndrome (MetS) components, consequences, and related conditions among a nationally representative sample of young and middle-aged adults. To that end, we analyzed data from the dental, oral, medical epidemiological (DOME) cross-sectional records-based study that combined comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of military personnel. Included were 132,529 subjects aged 18-50 who attended military dental clinics for one year. The prevalence of NAFLD in the study population was 0.7% (938/132,529). The following parameters maintained a statistically positive association with NAFLD in the multivariate analysis (from highest to lowest OR): male sex (OR = 3.91 (2.29-6.66)), hyperlipidemia (OR = 3.69 (2.75-4.95)), diabetes Type 2 (OR = 3.14 (2.21-4.46)), hypertension (OR = 1.67 (1.30-2.14)), periodontitis (OR = 1.42 (1.06-1.89)), body mass index (BMI) (OR = 1.15 (1.13-1.18)), and age (OR = 1.08 (1.06-1.09)). The multivariate analysis established a profile of the "patient vulnerable to NAFLD", including older age, male sex, and other MetS components, including diabetes type 2, hypertension, hyperlipidemia, BMI, and periodontitis. This profile aligns with the current new definition of metabolic dysfunction-associated fatty liver disease (MAFLD). We also analyzed the associations of the sum of the standard dental unit (SDU) scores of planned (SDU-P) and delivered (SDU-D) dental procedures per patient with NAFLD using receiver operating characteristic (ROC) analysis. The SDU-P (planned) score exhibited excellent discrimination for NAFLD (area under the curve (AUC) = 0.718 (0.703-0.734)). Overall, the results confirmed the hypothesis of this research, i.e., that NAFLD is associated with dental morbidity, particularly with periodontitis.
本研究旨在分析非酒精性脂肪性肝病（NAFLD）与牙齿参数之间的关联，同时控制社会人口统计学、健康相关习惯以及年轻和中年成年人全国代表性样本中的代谢综合征（MetS）各组成部分、后果及相关病症。为此，我们分析了基于牙科、口腔、医学流行病学（DOME）横断面记录的研究数据，该研究结合了军事人员全国代表性样本的综合社会人口统计学、医学和牙科数据库。纳入的是132,529名年龄在18至50岁之间、在军事牙科诊所就诊一年的受试者。研究人群中NAFLD的患病率为0.7%（938/132,529）。在多变量分析中，以下参数与NAFLD保持统计学上的正相关（按OR值从高到低排列）：男性（OR = 3.91（2.29 - 6.66））、高脂血症（OR = 3.69（2.75 - 4.95））、2型糖尿病（OR = 3.14（2.21 - 4.46））、高血压（OR = 1.67（1.30 - 2.14））、牙周炎（OR = 1.42（1.06 - 1.89））、体重指数（BMI）（OR = 1.15（1.13 - 1.18））和年龄（OR = 1.08（1.06 - 1.09））。多变量分析确定了“易患NAFLD患者”的特征，包括年龄较大、男性以及其他MetS组成部分，如2型糖尿病、高血压、高脂血症、BMI和牙周炎。这一特征与当前代谢功能障碍相关脂肪性肝病（MAFLD）的新定义相符。我们还使用受试者工作特征（ROC）分析，分析了每位患者计划（SDU - P）和已实施（SDU - D）牙科手术的标准牙科单位（SDU）评分总和与NAFLD的关联。SDU - P（计划）评分对NAFLD表现出良好的区分能力（曲线下面积（AUC） = 0.718（0.703 - 0.734））。总体而言，结果证实了本研究的假设，即NAFLD与牙科疾病相关，尤其是与牙周炎相关。
