Non-alcoholic fatty liver and periodontal disease in the adult population: Overview of systematic reviews

Authors

  • Héctor Fuentes-Barría Universidad Arturo Prat. Iquique, Chile Author https://orcid.org/0000-0003-0774-0848
  • Blanca Klahn-Acuña Universidad Andres Bello. Concepción, Chile Author
  • Denisse Sepúlveda-Toro Universidad Andres Bello. Concepción, Chile Author
  • Najarett Galaz-Cáceres Universidad Andres Bello. Concepción, Chile Author
  • Raúl Aguilera-Eguía Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción. Concepción, Chile Author https://orcid.org/0000-0002-4123-4255
  • Miguel Alarcón-Rivera Facultad de medicina, Universidad Católica del Maule, Chile Author https://orcid.org/0000-0001-8341-5567

DOI:

https://doi.org/10.56294/saludcyt2024.1016

Keywords:

Non-alcoholic Fatty Liver Disease, Periodontitis, Periodontal Diseases, Porphyromonas gingivalis, Quality of life

Abstract

Introduction: Periodontal disease is a chronic inflammatory condition affecting the periodontal supporting tissues. In addition to dental loss, it has been associated with various metabolic disorders, including obesity, diabetes, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD). This study aimed to analyze the effects of periodontal disease on the prevention and treatment of NAFLD in the adult population. Method: An electronic search of systematic reviews published between 2019 and 2024 was conducted in the Medline, Scopus, and Web of Science databases, as well as in the Epistemonikos meta-search engine. The search strategy was "Non-alcoholic Fatty Liver Disease AND Periodontitis". A total of 47 articles were identified, of which three systematic reviews with meta-analyses were analyzed. Results: The results indicated a potential association between periodontal disease and NAFLD, with an odds ratio (OR) of 1.48 (95% CI: 1.15 to 1.89; I² = 92%) and 1.91 (95% CI: 1.21 to 3.02; I² = 95%). However, this link has not been definitively proven, as heterogeneity decreases and the number of patients increases, resulting in an OR of 1.04 (95% CI: 0.97 to 1.12; I² = 58%). Conclusion: It is suggested that systemic inflammation and pro-inflammatory markers may play a significant role in the pathophysiology of both conditions. Nonetheless, further studies are needed to clarify this relationship and explore the common metabolic parameters.

References

Wijarnpreecha K, Panjawatanan P, Cheungpasitporn W, et al. The Association between Periodontitis and Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. J Gastrointestin Liver Dis. 2020;29(2):211-217. doi:10.15403/jgld-841.

Shin H-S. Association between periodontal status and non-alcoholic fatty liver disease in a Korean adult population: A nationwide cross-sectional study. J Periodontol. 2020;91:524–532. https://doi.org/10.1002/JPER.19-0291

Yoneda M, Kobayashi T, Iwaki M, Nogami A, Saito S, Nakajima A. Nonalcoholic Fatty Liver Disease as a Systemic Disease and the Need for Multidisciplinary Care. Gut Liver. 2023;17(6):843-852. doi:10.5009/gnl220545

Kuraji R, Sekino S, Kapila Y, Numabe Y. Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis. Periodontol 2000. 2021;87(1):204-240. doi:10.1111/prd.12387

Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. doi:10.1002/hep.28431

Akinkugbe AA, Barritt AS, Cai J, et al. Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos. J Periodontol. 2018;89(8):949-958. doi:10.1002/JPER.17-0579

Caetano VDS, de Andrade RSB, França LFC, et al. Food restriction reduces hepatic alterations associated with experimental periodontitis. J Periodontol. 2022;93(1):156-165. doi:10.1002/JPER.20-0772

Yao C, Lan D, Li X, Wang Y, Qi S. Porphyromonas gingivalis triggers inflammation in hepatocyte depend on ferroptosis via activating the NF-κB signaling pathway. Oral Dis. 2024;30(3):1680-1694. doi:10.1111/odi.14537

Nagasaki A, Sakamoto S, Arai T, et al. Elimination of Porphyromonas gingivalis inhibits liver fibrosis and inflammation in NASH. J Clin Periodontol. 2021;48(10):1367-1378. doi:10.1111/jcpe.13523

Liu L, Geng Y, Xiong C. Impact of Porphyromonas gingivalis-odontogenic infection on the pathogenesis of non-alcoholic fatty liver disease. Ann Med. 2023;55(2):2255825. doi:10.1080/07853890.2023.2255825

Kuraji R, Shiba T, Dong TS, Numabe Y, Kapila YL. Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J Gastroenterol. 2023;29(6):967-996. doi:10.3748/wjg.v29.i6.967

Xu F, Tang J. Is There An Association Between Periodontitis And Non-Alcoholic Fatty Liver Disease? A Systematic Review and Meta-Analysis. Community Dent Health. 2023;40(1):47-52. doi:10.1922/CDH_00180Xu06

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Disponible en: https://doi.org/10.1136/bmj.n71.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR-2: herramienta de evaluación crítica de revisiones sistemáticas de estudios de intervenciones de salud. BMJ. 2017;358:j4008.

Alakhali MS, Al-Maweri SA, Al-Shamiri HM, Al-Haddad K, Halboub E. The potential association between periodontitis and non-alcoholic fatty liver disease: a systematic review. Clin Oral Investig. 2018;22(9):2965-2974. doi:10.1007/s00784-018-2726-1

Thalla S, R K, A K. Increasing Risk Factors for Non-Alcoholic Fatty Liver Disease; an Insight into Chronic Periodontitis and Insulin Resistance. Endocr Metab Immune Disord Drug Targets. 2022;22(8):807-814. doi:10.2174/1871530322666220104095534

Kobayashi T, Iwaki M, Nogami A, et al. Involvement of Periodontal Disease in the Pathogenesis and Exacerbation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis: A Review. Nutrients. 2023;15(5):1269. doi:10.3390/nu15051269

Kuraji R, Shiba T, Dong TS, Numabe Y, Kapila YL. Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J Gastroenterol. 2023;29(6):967-996. doi:10.3748/wjg.v29.i6.967

Hatasa M, Yoshida S, Takahashi H, et al. Relationship between NAFLD and Periodontal Disease from the View of Clinical and Basic Research, and Immunological Response. Int J Mol Sci. 2021;22(7):3728. doi:10.3390/ijms22073728

Liu L, Geng Y, Xiong C. Impact of Porphyromonas gingivalis-odontogenic infection on the pathogenesis of non-alcoholic fatty liver disease. Ann Med. 2023;55(2):2255825. doi:10.1080/07853890.2023.2255825

Mei EH, Yao C, Chen YN, Nan SX, Qi SC. Multifunctional role of oral bacteria in the progression of non-alcoholic fatty liver disease. World J Hepatol. 2024;16(5):688-702. doi:10.4254/wjh.v16.i5.688

Albuquerque-Souza E, Sahingur SE. Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis. Periodontol 2000. 2022;89(1):125-141. doi:10.1111/prd.12427

Aguiar ILS, Santos-Lins LS, Brasil-Oliveira R, Cotrim HP, Lins-Kusterer L. Non-alcoholic fatty liver disease and periodontal disease: A systematic review and meta-analysis of cross-sectional studies. Arab J Gastroenterol. 2023;24(4):198-203. doi:10.1016/j.ajg.2023.09.005

Reis C, DA Costa AV, Guimarães JT, et al. Clinical improvement following therapy for periodontitis: Association with a decrease in IL-1 and IL-6. Exp Ther Med. 2014;8(1):323-327. doi:10.3892/etm.2014.1724

Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15(1):30-44. doi:10.1038/nri3785

Kim JY, Park YM, Lee GN, et al. Association between toothbrushing and non-alcoholic fatty liver disease. PLoS One. 2021;16(5):e0243686. doi:10.1371/journal.pone.0243686

Cardoso EM, Reis C, Manzanares-Céspedes MC. Chronic periodontitis, inflammatory cytokines, and interrelationship with other chronic diseases. Postgrad Med. 2018;130(1):98-104. doi:10.1080/00325481.2018.1396876

Butt K, Butt R, Sharma P. The burden of periodontal disease. Dental Update. 2019;46(10):907–13

Manuzza MA, Brito G, Echegaray NS, López LB. Glycemic index and glycemic load: their value in treatment and prevention of noncommunicable chronic diseases. Diaeta. 2018;36(162):29-38.

Orlandi M, Muñoz Aguilera E, Marletta D, Petrie A, Suvan J, D'Aiuto F. Impact of the treatment of periodontitis on systemic health and quality of life: A systematic review. J Clin Periodontol. 2022;49 Suppl 24:314-327. doi:10.1111/jcpe.13554

Kim JY, Lee GN, Song HC, Park YM, Ahn YB, Han K, et al. Association between Fatty Liver Index and Periodontitis: the Korea National Health and Nutrition Examination Survey. Sci Rep. 2020;10(1):3805.

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Published

2024-10-01

How to Cite

1.
Fuentes-Barría H, Klahn-Acuña B, Sepúlveda-Toro D, Galaz-Cáceres N, Aguilera-Eguía R, Alarcón-Rivera M. Non-alcoholic fatty liver and periodontal disease in the adult population: Overview of systematic reviews. Salud, Ciencia y Tecnología [Internet]. 2024 Oct. 1 [cited 2025 Apr. 4];4:.1016. Available from: https://sct.ageditor.ar/index.php/sct/article/view/1016