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Ding C, Shen Z, Xu R, Liu Y, Xu M, Fan C, Hu D, Xing T. Exosomes derived from periodontitis induce hepatic steatosis through the SCD-1/AMPK signaling pathway. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167343. [PMID: 38986822 DOI: 10.1016/j.bbadis.2024.167343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
AIM To investigate the impact of exosomes released by Porphyromonas gingivalis-Lipopolysaccharide activated THP-1 macrophages and human periodontal ligament fibroblasts on hepatocyte fat metabolism. RESULTS The liver of rats with experimental periodontitis showed obvious steatosis and inflammation compared with control rats. The culture supernatant of macrophages and human periodontal ligament fibroblasts (hPDLFs), when stimulated with Pg-LPS, induced lipogenesis in HepG2 cells. Furthermore, the lipid-promoting effect was effectively inhibited by the addition of the exosome inhibitor GW4869. Subsequently, we isolated exosomes from cells associated with periodontitis. Exosomes released by Pg-LPS-stimulated macrophages and hPDLFs are taken up by hepatocytes, causing mRNA expression related to fat synthesis, promoting triglyceride synthesis, and aggravating NAFLD progression. Finally, two sets of exosomes were injected into mice through the tail vein. In vivo experiments have also demonstrated that periodontitis-associated exosomes promote the development of hepatic injury and steatosis, upregulate SCD-1 expression and inhibit the AMPK signaling pathway. CONCLUSIONS In conclusion, we found that exosomes associated with periodontitis promote hepatocyte adipogenesis by increasing the expression of SCD-1 and suppressing the AMPK pathway, which indicates that close monitoring of the progression of stomatopathy associated extra-oral disorders is important and establishes a theoretical foundation for the prevention and management of fatty liver disease linked to periodontitis.
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Affiliation(s)
- Chunmeng Ding
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Zhenguo Shen
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Ruonan Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yajing Liu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Mengyue Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Chenyu Fan
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Dongyue Hu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China.
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Huang YQ, Xu JN, Huang Y, Xu YD, Wang HL, Shi WT, Wang J, Wang H. Independent and combined effects of smoking, drinking and depression on periodontal disease. BMC Oral Health 2024; 24:535. [PMID: 38711116 DOI: 10.1186/s12903-024-04287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Periodontitis is a complex chronic inflammatory disease that is particularly associated with health-related conditions such as smoking, excessive drinking and depression. This research aimed to investigate the interaction between these lifestyles factors on periodontitis risk. METHODS This study included participants who participated in the National Health and Nutrition Examination Survey in the United States between 2009 and 2014. They had completed oral health-periodontal examination, Smoking-Cigarette Use Questionnaire, Alcohol Use Questionnaire, and Patient Health Questionnaire. Periodontal clinical attachment loss (CAL) of 3 mm or more and Patient Health Questionnaire-9 (PHQ-9) of 10 scores or more were used to identify periodontitis and depression, respectively. Daily alcohol consumption in the past year was classified into three levels: low (1 drink or less), moderate (between 1 and 3 drinks), and heavy drinking (4 drinks or more), while smoking was defined as having smoked at least 100 cigarettes in one's lifetime. Then, the logistic regression combined with interaction models were used to analyze the independent and combined effects of smoking, drinking and depression on periodontitis risk. RESULTS The results indicated a statistically significant multiplicative interaction between smoking and depression in relation to the development of periodontitis, both in the overall population (P = 0.03) and among male participants (P = 0.03). Furthermore, among individuals experiencing depression, smoking was found to significantly increase the prevalence of periodontitis by 129% in the younger age group compared to non-smokers (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.10 to 4.76). However, the interaction between smoking and alcohol consumption was only significant among females (P < 0.05). There was a dose-dependent relationship between drinking frequency and smoking on periodontitis prevalence. In the smoking population, occasional drinking (OR: 1.70; 95% CI: 1.22 to 2.37) and regular drinking (OR: 2.28; 95% CI: 1.68 to 3.11) significantly increased the prevalence of periodontitis compared to individuals without these two factors. CONCLUSION These results suggested that there were interactive effects between smoking, drinking and depression on periodontitis risk and policies aimed at healthy behaviours and mental health may be beneficial for our oral health.
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Affiliation(s)
- Y Q Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China
| | - J N Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Y Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China
| | - Y D Xu
- Nanjing Medical University, Nanjing, China
| | - H L Wang
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China
| | - W T Shi
- Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - H Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China.
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Du M, Deng K, Cai Q, Hu S, Chen Y, Xu S, Tjakkes GHE, Ge S, Ge M, Li A. Mediating role of systemic inflammation in the association between heavy metals exposure and periodontitis risk. J Periodontol 2024; 95:502-514. [PMID: 37986691 DOI: 10.1002/jper.23-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND This study evaluated the mediating role of systemic inflammation in the association between exposure to heavy metals and periodontitis in a nationwide sample of adults. METHODS Pooled cross-sectional data from the National Health and Nutrition Examination Survey (NHANES 2009-2014) were used (n = 8993). Periodontitis was defined by a full-mouth examination and classified as no/mild and moderate/severe (mod/sev) groups. Blood and urinary heavy metal levels were investigated, including cadmium (Cd), lead (Pb), and mercury (Hg). In addition, systemic inflammation was assessed using circulatory leukocyte counts and C-reactive protein (CRP) levels. RESULTS Multivariable logistic regression analysis revealed the positive associations of blood and urinary levels of Cd and Pb with mod/sev periodontitis. In contrast,blood Hg levels did not show a significant association. The odds of having periodontitis were 1.233 and 1.311 times higher for each one-unit increment in Ln-transformed blood Cd (95% confidence interval [CI]: 1.109-1.371) and Pb (95% CI: 1.170-1.470), respectively. Mediation analysis suggested a 6.3% to 11.5% contribution of leucocyte counts in the association of blood Cd and Pb levels with periodontitis. Sensitivity analyses for urinary Cd levels yielded consistent mediating effects. However, no significant mediating effect of CRP was detected. CONCLUSION Higher exposures to Cd and Pb were positively associated with periodontitis risk. These associations might be partially mediated by the elevated levels of leukocytes rather than CRP. Further longitudinal studies are needed to elucidate the discordant results of the systemic inflammatory biomarkers.
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Affiliation(s)
- Mi Du
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
- Clinical Research Center for Cancer of Zhejiang Province, Hangzhou, China
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Qingqing Cai
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Shixian Hu
- Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Gastroenterology and Hepatology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Yuntao Chen
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Geerten-Has E Tjakkes
- Department of Periodontology, Center for Dentistry and Oral Hygiene, UMCG, University of Groningen, Groningen, The Netherlands
| | - Shaohua Ge
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Minghua Ge
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
- Clinical Research Center for Cancer of Zhejiang Province, Hangzhou, China
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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Liu M, Wu Y, Song J, He W. Association of Sleep Duration with Tooth Loss and Periodontitis: Insights from the National Health and Nutrition Examination Surveys (2005-2020). Sleep Breath 2024; 28:1019-1033. [PMID: 38147286 DOI: 10.1007/s11325-023-02966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Sleep disorders such as insomnia, apnea, and restless leg syndrome can negatively affect a person's overall health and may cause hypertension, heart failure, and coronary heart disease. Likewise, periodontitis, a gum disease, can lead to both physical and psychological health issues, exerting a considerable effect on one's overall well-being-periodontitis stands as a primary cause of tooth loss. Nevertheless, there has been insufficient research on the correlation between the amount of sleep individuals get and the occurrence of periodontitis/tooth loss among Americans. Therefore, this study aimed to assess the influence of sleep length on periodontitis in the American population. METHODS Periodontitis severity was classified (none, mild, moderate, and severe) using American Periodontal Association criteria. Sleep duration was assessed by self-reported data and categorized into three groups (deficient, adequate, and excessive). Tooth loss was assessed by the oral examination. To establish a connection between the duration of sleep and periodontitis/tooth loss, a weighted multivariable logistic regression analysis was employed. A GAM analysis and smooth curve fitting assessment were conducted to identify non-linear relationships. Subgroup, interaction, and mediation analyses were also performed. RESULTS The prevalence of tooth loss was significantly high, affecting 96.4% of the individuals, whereas 46.6% of the study sample experienced moderate to severe periodontitis. The average age of participants was 52.7 years. After adjusting for potential confounding factors, the analysis of weighted multivariable logistic regression revealed a significant association between sleep insufficiency and moderate/severe periodontitis (OR 1.15, 95% CI 1.01-1.30, P = 0.0298), as well as tooth loss (OR 1.16, 95% CI 1.01-1.33, P = 0.0371). Additionally, the research showed a correlation between the length of sleep and periodontitis that followed a U-shaped pattern. In addition, the analysis of mediation revealed that high blood pressure explained 7.0% (95% CI 4.0% to 12.9%; P < 0.0001) of the link between the amount of sleep and the likelihood of losing teeth. CONCLUSION Sleep duration was independently correlated with moderate/severe periodontitis/tooth loss and had a non-linear relationship.
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Affiliation(s)
- Manyi Liu
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - Yadong Wu
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China.
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
| | - Wei He
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China.
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
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Zhang Y, He TC, Zhang H. The impact of metabolic disorders on management of periodontal health in children. PEDIATRIC DISCOVERY 2024; 2:e38. [PMID: 38784180 PMCID: PMC11115384 DOI: 10.1002/pdi3.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/10/2023] [Indexed: 05/25/2024]
Abstract
Periodontitis is a chronic inflammatory disease caused by plaque biofilm which shares risk factors with systemic chronic diseases such as diabetes, cardiovascular disease, and osteoporosis. Many studies have found increased prevalence and rate of progression of periodontal disease in children with common metabolic disorders. Although the causal relationship and specific mechanism between them has not been determined yet. The aim of this paper is to progress on the impact of metabolic disorders on periodontal health in children and the underlying mechanisms, which provides new evidences for the prevention and intervention of metabolic disorders and periodontitis in children.
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Affiliation(s)
- Yunyan Zhang
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Pediatric Dentistry, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
| | - Tong-Chuan He
- Molecular Oncology Laboratory, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL, USA
| | - Hongmei Zhang
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Pediatric Dentistry, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
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6
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Kaneva AM, Bojko ER. Fatty liver index (FLI): more than a marker of hepatic steatosis. J Physiol Biochem 2024; 80:11-26. [PMID: 37875710 DOI: 10.1007/s13105-023-00991-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023]
Abstract
Fatty liver index (FLI) was developed as a simple and accurate marker of hepatic steatosis. FLI is derived from an algorithm based on body mass index, waist circumference, and levels of triglycerides and gamma-glutamyltransferase, and it is widely used in clinical and epidemiological studies as a screening tool for discriminating between healthy and nonalcoholic fatty liver disease (NAFLD) subjects. However, a systematic review of the literature regarding FLI revealed that this index has more extensive relationships with biochemical and physiological parameters. FLI is associated with key parameters of lipid, protein and carbohydrate metabolism, hormones, vitamins and markers of inflammation, or oxidative stress. FLI can be a predictor or risk factor for a number of metabolic and nonmetabolic diseases and mortality. FLI is also used as an indicator for determining the effects of health-related prevention interventions, medications, and toxic substances on humans. Although in most cases, the exact mechanisms underlying these associations have not been fully elucidated, they are most often assumed to be mediated by insulin resistance, inflammation, and oxidative stress. Thus, FLI may be a promising marker of metabolic health due to its multiple associations with parameters of physiological and pathological processes. In this context, the present review summarizes the data from currently available literature on the associations between FLI and biochemical variables and physiological functions. We believe that this review will be of interest to researchers working in this area and can provide new perspectives and directions for future studies on FLI.
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Affiliation(s)
- Anastasiya M Kaneva
- Institute of Physiology of Кomi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, 50 Pervomayskaya str., 167982, Syktyvkar, Russia.
| | - Evgeny R Bojko
- Institute of Physiology of Кomi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, 50 Pervomayskaya str., 167982, Syktyvkar, Russia
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Kuraji R, Ye C, Zhao C, Gao L, Martinez A, Miyashita Y, Radaic A, Kamarajan P, Le C, Zhan L, Range H, Sunohara M, Numabe Y, Kapila YL. Nisin lantibiotic prevents NAFLD liver steatosis and mitochondrial oxidative stress following periodontal disease by abrogating oral, gut and liver dysbiosis. NPJ Biofilms Microbiomes 2024; 10:3. [PMID: 38233485 PMCID: PMC10794237 DOI: 10.1038/s41522-024-00476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024] Open
Abstract
Oral microbiome dysbiosis mediates chronic periodontal disease, gut microbial dysbiosis, and mucosal barrier disfunction that leads to steatohepatitis via the enterohepatic circulation. Improving this dysbiosis towards health may improve liver disease. Treatment with antibiotics and probiotics have been used to modulate the microbial, immunological, and clinical landscape of periodontal disease with some success. The aim of the present investigation was to evaluate the potential for nisin, an antimicrobial peptide produced by Lactococcus lactis, to counteract the periodontitis-associated gut dysbiosis and to modulate the glycolipid-metabolism and inflammation in the liver. Periodontal pathogens, namely Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia and Fusobacterium nucleatum, were administrated topically onto the oral cavity to establish polymicrobial periodontal disease in mice. In the context of disease, nisin treatment significantly shifted the microbiome towards a new composition, commensurate with health while preventing the harmful inflammation in the small intestine concomitant with decreased villi structural integrity, and heightened hepatic exposure to bacteria and lipid and malondialdehyde accumulation in the liver. Validation with RNA Seq analyses, confirmed the significant infection-related alteration of several genes involved in mitochondrial dysregulation, oxidative phosphorylation, and metal/iron binding and their restitution following nisin treatment. In support of these in vivo findings indicating that periodontopathogens induce gastrointestinal and liver distant organ lesions, human autopsy specimens demonstrated a correlation between tooth loss and severity of liver disease. Nisin's ability to shift the gut and liver microbiome towards a new state commensurate with health while mitigating enteritis, represents a novel approach to treating NAFLD-steatohepatitis-associated periodontal disease.
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Affiliation(s)
- Ryutaro Kuraji
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Changchang Ye
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontology, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Chuanjiang Zhao
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Department of Periodontology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Li Gao
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Department of Periodontology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - April Martinez
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - Yukihiro Miyashita
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Allan Radaic
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Sections of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Pachiyappan Kamarajan
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Sections of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Charles Le
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - Ling Zhan
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - Helene Range
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Department of Periodontology, University of Rennes, UFR of Odontology; Service d'Odontologie, CHU de Rennes, Rennes, France
- INSERM CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer); CIC 1414, Rennes, France
| | - Masataka Sunohara
- Department of Anatomy, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yvonne L Kapila
- Orofacial Sciences Department, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA.
- Sections of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA.
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Song J, Wu Y, Ma H, Zhang J. Association between muscle quality index and periodontal disease among American adults aged ≥ 30 years: a cross-sectional study and mediation analysis. BMC Oral Health 2023; 23:918. [PMID: 38001472 PMCID: PMC10675865 DOI: 10.1186/s12903-023-03520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/10/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE The muscle quality index (MQI) is a measurement of muscle quality that is directly related to overall health. There has been little study on the relationship between the muscle quality index and periodontitis in American people beyond 30 years. Therefore, this study aimed to explore the link between periodontitis and Muscle quality index (MQI) in older Americans. METHODS Three thousand two hundred fifty-eight individuals (aged 30 to 59) who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were considered eligible for the cross-sectional investigation. A hand dynamometer was used to determine the handgrip strength (HGS). Dual-energy X-ray absorptiometry was employed to calculate ASM (DXA). MQIArm was calculated by dividing the dominant hand's HGS by the dominant arm's ASM (in kg/kg). MQIApp was calculated by dividing the dominant hand's HGS by the ASM (in kg/kg). MQItotal was calculated by dividing the sum of the dominant and non-dominant hands by the ASM (in kg/kg). To investigate the link between muscle quality index and periodontal disease, the weighted multivariable logistic regression models were used. Using generalized additive models, it was determined if a nonlinear connection existed. Then, we developed a two-piece linear regression model and calculated the inflection point using a recursive approach. A mediation study was performed to determine how much of the impact of MQItotal on periodontitis was mediated by potential variables. RESULTS Three thousand two hundred fifty-eight participants from the United States were enrolled. The OR (95% CI) for the relationship between MQItotal and periodontitis in the regression model with fully adjusted variables was 0.69 (0.53-0.91), for the connection between MQIArm and periodontitis was 0.90 (0.84-0.97), and for the association between MQIApp and periodontitis was 0.49 (0.30-0.80). MQItotal and periodontitis were shown to have a J-shaped relationship with a change point of 3.64. Before the change point, the OR (95% CI) was 0.69 (0.58, 0.82). In the analysis of drinking and married status, the interaction was statistically significant. Analysis of mediation showed that alcohol use was responsible for 0.4% (0.10 to 1.2) of the effect of MQItotal on periodontitis. CONCLUSION In American adults aged over 30, the Muscle Quality Index (MQI) exhibited an independent negative correlation with moderate to severe periodontitis, demonstrating a J-shaped relationship. Furthermore, alcohol consumption may act as a mediator in the association between MQI and periodontitis.
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Affiliation(s)
- Jukun Song
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China
| | - Yadong Wu
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China
| | - Hong Ma
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China.
| | - Junmei Zhang
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China.
- Department of Orthodontics, the Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
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9
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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; 17:843-852. [PMID: 37560797 PMCID: PMC10651384 DOI: 10.5009/gnl220545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 08/11/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease, and there has been a rapid increase in cases worldwide. NAFLD is rapidly becoming the leading cause of hepatocellular carcinoma and is also associated with an increased risk of cardiovascular disease or exacerbation of other organ diseases, thus posing a significant health problem from both a medical and a socioeconomic perspective. NAFLD is a systemic disease and requires the involvement of numerous medical professionals. Multidisciplinary collaboration, in which different professionals within different specialties come together and work together toward a common goal, supports better patient care by integrating perspectives of multiple experts and facilitating the exchange of opinions. Due to the large number of potential patients, gastroenterologists and hepatologists cannot manage the patients alone, and collaboration between specialists in various fields, including family doctors, dentists, nutritionists, and pharmacists is required for treatment of NAFLD. This review will discuss NAFLD from the perspective of various specialties and introduce multidisciplinary collaboration.
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Affiliation(s)
- Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Satoru Saito
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
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10
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Lu Z, Li Y, Chowdhury N, Yu H, Syn WK, Lopes-Virella M, Yilmaz Ö, Huang Y. The Presence of Periodontitis Exacerbates Non-Alcoholic Fatty Liver Disease via Sphingolipid Metabolism-Associated Insulin Resistance and Hepatic Inflammation in Mice with Metabolic Syndrome. Int J Mol Sci 2023; 24:8322. [PMID: 37176029 PMCID: PMC10179436 DOI: 10.3390/ijms24098322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Clinical studies have shown that periodontitis is associated with non-alcoholic fatty liver disease (NAFLD). However, it remains unclear if periodontitis contributes to the progression of NAFLD. In this study, we generated a mouse model with high-fat diet (HFD)-induced metabolic syndrome (MetS) and NAFLD and oral P. gingivalis inoculation-induced periodontitis. Results showed that the presence of periodontitis increased insulin resistance and hepatic inflammation and exacerbated the progression of NAFLD. To determine the role of sphingolipid metabolism in the association between NAFLD and periodontitis, we also treated mice with imipramine, an inhibitor of acid sphingomyelinase (ASMase), and demonstrated that imipramine treatment significantly alleviated insulin resistance and hepatic inflammation, and improved NAFLD. Studies performed in vitro showed that lipopolysaccharide (LPS) and palmitic acid (PA), a major saturated fatty acid associated with MetS and NAFLD, synergistically increased the production of ceramide, a bioactive sphingolipid involved in NAFLD progression in macrophages but imipramine effectively reversed the ceramide production stimulated by LPS and PA. Taken together, this study showed for the first time that the presence of periodontitis contributed to the progression of NAFLD, likely due to alterations in sphingolipid metabolism that led to exacerbated insulin resistance and hepatic inflammation. This study also showed that targeting ASMase with imipramine improves NAFLD by reducing insulin resistance and hepatic inflammation.
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Affiliation(s)
- Zhongyang Lu
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Yanchun Li
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nityananda Chowdhury
- Department of Oral Health Sciences, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Hong Yu
- Department of Oral Health Sciences, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Wing-Kin Syn
- Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Saint Louis, MI 63110, USA
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Universidad del Pa S Vasco/Euskal Herriko Univertsitatea (UPV/EHU), 48940 Leioa, Spain
| | - Maria Lopes-Virella
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401, USA
| | - Özlem Yilmaz
- Department of Oral Health Sciences, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Yan Huang
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401, USA
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11
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Kobayashi T, Iwaki M, Nogami A, Honda Y, Ogawa Y, Imajo K, Saito S, Nakajima A, Yoneda M. Involvement of Periodontal Disease in the Pathogenesis and Exacerbation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis: A Review. Nutrients 2023; 15:nu15051269. [PMID: 36904268 PMCID: PMC10004797 DOI: 10.3390/nu15051269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
The increasing incidence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), along with global lifestyle changes, requires further in-depth research to elucidate the mechanisms and develop new treatment strategies. In addition, the number of patients with periodontal disease has increased recently, suggesting that periodontal disease is sometimes associated with systemic conditions. In this review, we summarize recent studies linking periodontal disease and NAFLD, the concept of the mouth-gut-liver axis, oral and intestinal microbiota, and liver disease. We suggest new research directions toward a detailed mechanistic understanding and novel targets for treatment and prevention. Forty years have passed since the concepts of NAFLD and NASH were first proposed. however, no effective prevention or treatment has been established. We also found that the pathogenesis of NAFLD/NASH is not limited to liver-related diseases but has been reported to be associated with various systemic diseases and an increasing number of causes of death. In addition, changes in the intestinal microbiota have been shown to be a risk factor for periodontal diseases, such as atherosclerosis, diabetes, rheumatoid arthritis, nonalcoholic fatty liver disease, and obesity.
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Affiliation(s)
- Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Yasushi Honda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Yuji Ogawa
- National Hospital Organization Yokohama Medical Center, Gastroenterology Division, 3-60-2 Harajyuku, Yokohama 245-8575, Japan
| | - Kento Imajo
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, 255 Tsuko, Furusawa, Kawasaki 215-0026, Japan
| | - Satoru Saito
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
- Correspondence: ; Tel.: +81-45-787-2640
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12
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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; 29:967-996. [PMID: 36844143 PMCID: PMC9950865 DOI: 10.3748/wjg.v29.i6.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/14/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
A growing body of evidence from multiple areas proposes that periodontal disease, accompanied by oral inflammation and pathological changes in the microbiome, induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). A subgroup of NAFLD patients have a severely progressive form, namely nonalcoholic steatohepatitis (NASH), which is characterized by histological findings that include inflammatory cell infiltration and fibrosis. NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma. The oral microbiota may serve as an endogenous reservoir for gut microbiota, and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis. Gut dysbiosis increases the production of potential hepatotoxins, including lipopolysaccharide, ethanol, and other volatile organic compounds such as acetone, phenol and cyclopentane. Moreover, gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall, leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation. In particular, many animal studies support that oral administration of Porphyromonas gingivalis, a typical periodontopathic bacterium, induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis. NAFLD, also known as the hepatic phenotype of metabolic syndrome, is strongly associated with metabolic complications, such as obesity and diabetes. Periodontal disease also has a bidirectional relationship with metabolic syndrome, and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively. In this review, we will describe the link between periodontal disease and NAFLD with a focus on basic, epidemiological, and clinical studies, and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome. In conclusion, it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease, gut microbiota, and metabolic syndrome. Thus, the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics, prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-0071, Japan
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Takahiko Shiba
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tien S Dong
- The Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Department of Medicine, University of California David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-8159, Japan
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
- Sections of Biosystems and Function and Periodontics, Professor and Associate Dean of Research, Felix and Mildred Yip Endowed Chair in Dentistry, University of California Los Angeles, Los Angeles, CA 90095, United States
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13
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Jiaxin H, Zhu C, Jing Y, Qianhui S, Fuqian J, Qiyuan P, Yi L, Jukun S. Plasma elaidic acid level is associated with periodontal health in American adults: A cross-sectional study. Front Nutr 2022; 9:1034841. [PMID: 36570162 PMCID: PMC9773206 DOI: 10.3389/fnut.2022.1034841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background Whether there is an association between TFAs and periodontitis is unclear. The purpose of this study was to investigate the relationship between moderate/severe periodontitis and plasma level of elaidic acid, a major trans-fatty acid component, in American adults. Methods The National Health and Nutrition Examination Survey (NHANES) years 2009-2010 were used to screen a total of 1,610 people. The independent variable of interest is plasma elaidic acid level, the dependent variable is periodontitis, and the covariates include socio-demographic variables, lifestyle variables, systemic diseases, etc. The distribution of variables in the covariate differences between the different independent groups according to tertile was investigated using a multiple linear regression model. To examine the association between plasma elaidic acid levels and moderate/severe periodontitis, three models were used. Results Multiple logistic regression analysis showed a significant association between plasma elaidic acid level and moderate/severe periodontitis after adjustment for potential confounders (OR = 1.021, 95%CI: 1.004-1.039, P = 0.01394). Subjects with the highest tertile of plasma elaidic acid levels were 51.9% more likely to have periodontitis compared with subjects with the lowest tertile of plasma elaidic acid levels (OR = 1.519, 95% CI: 1.136-2.030, P = 0.00477). No possible sources of heterogeneity were identified in the subgroup analyses. Conclusion Plasma elaidic acid levels are associated with periodontal disease in American adults.
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Affiliation(s)
- Hu Jiaxin
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Chen Zhu
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Yang Jing
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Shi Qianhui
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Jin Fuqian
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Pang Qiyuan
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Luo Yi
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China,*Correspondence: Luo Yi,
| | - Song Jukun
- The Affiliated Stomatological Hospital and Stomatology of Guizhou Medical University, Guizhou Medical University, Guiyang, China,Song Jukun,
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14
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Ram D, Wilensky A, Zur D, Almoznino G. The Triangle of Nonalcoholic Fatty Liver Disease, Metabolic Dysfunction, and Periodontitis: Analysis of the Dental, Oral, Medical and Epidemiological (DOME) Records-Based Nationwide Research. Metabolites 2022; 12:metabo12121212. [PMID: 36557250 PMCID: PMC9780834 DOI: 10.3390/metabo12121212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
- Doron Ram
- In Partial Fulfillment DMD Thesis, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Asaf Wilensky
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Periodontology, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Dorit Zur
- Medical Information Department, General Surgeon Headquarter, Medical Corps, Israel Defense Forces, Tel Hashomer 02149, Israel
| | - Galit Almoznino
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Big Biomedical Data Research Laboratory; Dean’s Office, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Endodontics, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hadassah Medical Center, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +97-226-776-194; Fax: +97-226-447-919
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15
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Shin HS, Hong MH, Moon JY, Sim SJ. Periodontal disease could be a potential risk factor for non-alcoholic fatty liver disease: An 11-year retrospective follow-up study. Clin Oral Investig 2022; 26:5503-5514. [PMID: 35556175 DOI: 10.1007/s00784-022-04518-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/23/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association of periodontal disease with non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS A retrospective follow-up study using the National Health Insurance Service-National Sample Cohort was performed from 2002 to 2015 in the Korean population. A total of 165,032 subjects were followed up for incident NAFLD during 11 years. Periodontal disease and NAFLD were defined by a diagnosis using the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes. Periodontal status was used as the severity of periodontal status and the number of dental visit due to PD. RESULTS Periodontitis was associated with a 4% increase in risk for NAFLD after adjusting for socio-demographic factor, health behaviors, and systemic diseases (adjusted hazard ratio [aHR] = 1.04, 95% CI = 1.01 to 1.07). Between the number of dental visit due to PD and the risk for NAFLD was observed a dose-effect association (aHR = 1.02, 95% CI = 0.99 to 1.05 for once; aHR = 1.10, 95% CI = 1.06 to 1.15 for two times; aHR = 1.14, 95% CI = 1.06 to 1.24 for three times). CONCLUSIONS Our data confirmed that periodontitis showed an association with a higher incidence of NAFLD. CLINICAL RELEVANCE Prevention and management of periodontal disease could be beneficial for reducing the risk of NAFLD.
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Affiliation(s)
- Hye-Sun Shin
- Department of Dental Hygiene, Baekseok University, (31065) 1 Baekseokdehak-Ro, Dongnam-Gu, Cheonan, Chungnam, South Korea.,Big Data Statistics Institute, Cheonan, South Korea
| | - Min-Hee Hong
- Department of Dental Hygiene, Baekseok University, (31065) 1 Baekseokdehak-Ro, Dongnam-Gu, Cheonan, Chungnam, South Korea
| | - Ja-Young Moon
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, (03722) 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, South Korea.
| | - Seon-Ju Sim
- Department of Dental Hygiene, Baekseok University, (31065) 1 Baekseokdehak-Ro, Dongnam-Gu, Cheonan, Chungnam, South Korea.,Big Data Statistics Institute, Cheonan, South Korea
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16
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Wu L, Shi R, Bai H, Wang X, Wei J, Liu C, Wu Y. Porphyromonas gingivalis Induces Increases in Branched-Chain Amino Acid Levels and Exacerbates Liver Injury Through livh/livk. Front Cell Infect Microbiol 2022; 12:776996. [PMID: 35360107 PMCID: PMC8961321 DOI: 10.3389/fcimb.2022.776996] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Porphyromonas gingivalis, a keystone periodontal pathogen, has emerged as a risk factor for systemic chronic diseases, including non-alcoholic fatty liver disease (NAFLD). To clarify the mechanism by which this pathogen induces such diseases, we simultaneously analyzed the transcriptome of intracellular P. gingivalis and infected host cells via dual RNA sequencing. Pathway analysis was also performed to determine the differentially expressed genes in the infected cells. Further, the infection-induced notable expression of P. gingivalis livk and livh genes, which participate in branched-chain amino acid (BCAA) transfer, was also analyzed. Furthermore, given that the results of recent studies have associated NAFLD progression with elevated serum BCAA levels, which reportedly, are upregulated by P. gingivalis, we hypothesized that this pathogen may induce increases in serum BCAA levels and exacerbate liver injury via livh/livk. To verify this hypothesis, we constructed P. gingivalis livh/livk-deficient strains (Δlivk, Δlivh) and established a high-fat diet (HFD)-fed murine model infected with P. gingivalis. Thereafter, the kinetic growth and exopolysaccharide (EPS) production rates as well as the invasion efficiency and in vivo colonization of the mutant strains were compared with those of the parental strain. The serum BCAA and fasting glucose levels of the mice infected with either the wild-type or mutant strains, as well as their liver function were also further investigated. It was observed that P. gingivalis infection enhanced serum BCAA levels and aggravated liver injury in the HFD-fed mice. Additionally, livh deletion had no effect on bacterial growth, EPS production, invasion efficiency, and in vivo colonization, whereas the Δlivk strain showed a slight decrease in invasion efficiency and in vivo colonization. More importantly, however, both the Δlivk and Δlivh strains showed impaired ability to upregulate serum BCAA levels or exacerbate liver injury in HFD-fed mice. Overall, these results suggested that P. gingivalis possibly aggravates NAFLD progression in HFD-fed mice by increasing serum BCAA levels, and this effect showed dependency on the bacterial BCAA transport system.
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Affiliation(s)
- Leng Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Department of Periodontics, Sichuan University, Chengdu, China
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Department of Periodontics, Sichuan University, Chengdu, China
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Huimin Bai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Department of Periodontics, Sichuan University, Chengdu, China
| | - Xingtong Wang
- Department of Hematology, Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jian Wei
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengcheng Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Department of Periodontics, Sichuan University, Chengdu, China
- *Correspondence: Chengcheng Liu, ; Yafei Wu,
| | - Yafei Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Department of Periodontics, Sichuan University, Chengdu, China
- *Correspondence: Chengcheng Liu, ; Yafei Wu,
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17
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Oral Health and Liver Disease: Bidirectional Associations—A Narrative Review. Dent J (Basel) 2022; 10:dj10020016. [PMID: 35200242 PMCID: PMC8870998 DOI: 10.3390/dj10020016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 12/04/2022] Open
Abstract
Several links between chronic liver disease and oral health have been described and are discussed in this narrative review. Oral manifestations such as lichen planus, ulcers, xerostomia, erosion and tongue abnormalities seem to be particularly prevalent among patients with chronic liver disease. These may be causal, coincidental, secondary to therapeutic interventions, or attributable to other factors commonly observed in liver disease patients. In addition, findings from both experimental and epidemiological studies suggest that periodontitis can induce liver injury and contribute to the progression of chronic liver disease through periodontitis-induced systemic inflammation, endotoxemia, and gut dysbiosis with increased intestinal translocation. This has brought forward the hypothesis of an oral-gut-liver axis. Preliminary clinical intervention studies indicate that local periodontal treatments may lead to beneficial liver effects, but more human studies are needed to clarify if treatment of periodontitis truly can halt or reverse progression of liver disease and improve liver-related outcomes.
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18
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Xing T, Liu Y, Cheng H, Bai M, Chen J, Ji H, He M, Chen K. Ligature induced periodontitis in rats causes gut dysbiosis leading to hepatic injury through SCD1/AMPK signalling pathway. Life Sci 2022; 288:120162. [PMID: 34813797 DOI: 10.1016/j.lfs.2021.120162] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS Previous studies have demonstrated that chronic periodontitis (CP) is closely associated with the occurrence and development of a variety of systemic diseases. In this study, we successfully constructed a rat CP model through dental silk ligation, and the corresponding inflammatory reactions and fatty lesions were observed in the liver. MAIN METHODS Sprague-Dawley rats (n = 6) underwent tooth ligation at the bilateral first molars with silk thread to induce CP and were sacrificed 8 weeks later and compared to non-ligated rats (n = 6). RNA sequencing and 16S rRNA analysis were performed to determine the molecular mechanisms of CP involved in inducing liver disease. Alveolar bone loss, liver enzymes, mandible and liver histopathology, and inflammatory responses were compared between groups. KEY FINDINGS RNA sequencing of liver tissue showed that the expression of SCD1 increased significantly in CP rats compared to controls. KEGG enrichment analysis showed that the AMPK signalling pathway may be involved in liver steatosis. The intestinal flora of faecal samples of rats were analysed by 16S rRNA sequencing, and the results indicated that the intestinal flora of the CP group was evidently imbalanced. The expression levels of tight junction proteins (ZO-1, occludin, and claudin-1) were significantly reduced in CP rats. Meanwhile, increases in serum IL-1β and lipopolysaccharide in CP rats reflected a systemic inflammatory response. SIGNIFICANCE CP may be involved in the occurrence and development of hepatic injury and liver steatosis, and its mechanism may be related to the oral-gut-liver axis and SCD1/AMPK signal activation in the liver.
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Affiliation(s)
- Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yajing Liu
- Department of Public Health Inspection and Quarantine, Anhui Medical University School of Public Health, Hefei, Anhui 230032, China
| | - Huixin Cheng
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Miaomiao Bai
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Jingning Chen
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Provincial Key Laboratory of Zoonoses of High Institutions in Anhui, Hefei 230032, China
| | - Huafeng Ji
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Provincial Key Laboratory of Zoonoses of High Institutions in Anhui, Hefei 230032, China
| | - Maozhang He
- Department of Microbiology, The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei 230022, China.
| | - Keyang Chen
- Department of Public Health Inspection and Quarantine, Anhui Medical University School of Public Health, Hefei, Anhui 230032, China.
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19
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Association between liver cirrhosis and peri-implant diseases: a case-control study on implant- and patient-related risk factors. Clin Oral Investig 2021; 26:3563-3572. [PMID: 34859326 DOI: 10.1007/s00784-021-04324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/27/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the potential association between liver cirrhosis and peri-implant diseases, as well as the influence of different risk indicators on this association. METHODS This case-control study included 64 cases with liver cirrhosis and 128 controls without liver diseases that presented the same socio-demographic and economic profile. The specific inclusion criteria were the following: aged group of 35-55 years and presenting at least one osseointegrated implant functioning for >5 years. A full-mouth peri-implant and periodontal examination was performed and risk variables were recorded. The association between risk variables and the occurrence of peri-implant diseases was tested through univariate analysis and multivariate logistic regression, stratified by alcohol status. Additionally, a mediation analysis was performed to examine the mediating effect of age with peri-implantitis. RESULTS A high prevalence of peri-implantitis (29.7%) was observed among cases when compared to controls (18.0%). Individuals with cirrhosis presented ~2.5 higher chance of having peri-implantitis than controls (p<0.001). Significant variables associated with the occurrence of peri-implantitis in the final logistic model were the following: cirrhosis, alcohol use, age (>55 years), male sex, smoking, periodontitis, and number of ≤14. CONCLUSIONS An important risk association between liver cirrhosis and peri-implantitis was reported. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and liver cirrhosis. CLINICAL RELEVANCE Cirrhosis individuals, age, and periodontitis, as well as alcohol use and smoking interaction, should be considered as potential risk indicators for peri-implantitis.
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20
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Ezhilarasan D. Deciphering the toxicological role of Porphyromonas gingivalis derived endotoxins in liver diseases. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 88:103755. [PMID: 34662732 DOI: 10.1016/j.etap.2021.103755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
Periodontitis is a most prevalent and infectious multifactorial inflammatory disease and is characterized by the progressive destruction of the tooth-supporting tissues. Porphyromonas gingivalis, a Gram‑negative oral anaerobe, mainly causes periodontitis and it is one of the most important risk factors responsible for aggravation of existing systemic diseases. Several experimental and clinical studies have shown the positive association between periodontitis and different forms of liver disease. Periodontal diseases increase the prevalence of non-alcoholic fatty liver diseases and cirrhosis. Infected periodontium and pathogens in the periodontal microenvironments release pathogen-associated molecular patterns such as peptidoglycan, lipopolysaccharides, gingipain, fimbria, bacterial DNA, etc, and damage-associated molecular patterns such as interleukins-1α, β, - 8, and galectin-3, etc. These virulence factors and cytokines enter the bloodstream, disseminate into the whole body, and induce a variety of systemic pathological effects, including liver diseases (steatosis and fibrosis). Maintaining oral hygiene by scaling and root planning significantly improves liver damage in patients with periodontitis. Dentists and physicians should have more awareness in understanding the bidirectional nature of the relationship between oral and systemic diseases. Importantly, periodontitis condition aggravates simple fatty liver into fibrotic disease and therefore, the aim of this review is to understand the possible link between periodontitis and liver diseases.
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Affiliation(s)
- Devaraj Ezhilarasan
- Department of Pharmacology, The Blue Lab, Molecular Medicine and Toxicology Division, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 600 077, India.
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21
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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; 87:204-240. [PMID: 34463983 PMCID: PMC8456799 DOI: 10.1111/prd.12387] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontal disease, a chronic inflammatory disease of the periodontal tissues, is not only a major cause of tooth loss, but it is also known to exacerbate/be associated with various metabolic disorders, such as obesity, diabetes, dyslipidemia, and cardiovascular disease. Recently, growing evidence has suggested that periodontal disease has adverse effects on the pathophysiology of liver disease. In particular, nonalcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome, has been associated with periodontal disease. Nonalcoholic fatty liver disease is characterized by hepatic fat deposition in the absence of a habitual drinking history, viral infections, or autoimmune diseases. A subset of nonalcoholic fatty liver diseases can develop into more severe and progressive forms, namely nonalcoholic steatohepatitis. The latter can lead to cirrhosis and hepatocellular carcinoma, which are end‐stage liver diseases. Extensive research has provided plausible mechanisms to explain how periodontal disease can negatively affect nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, namely via hematogenous or enteral routes. During periodontitis, the liver is under constant exposure to various pathogenic factors that diffuse systemically from the oral cavity, such as bacteria and their by‐products, inflammatory cytokines, and reactive oxygen species, and these can be involved in disease promotion of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Also, gut microbiome dysbiosis induced by enteral translocation of periodontopathic bacteria may impair gut wall barrier function and promote the transfer of hepatotoxins and enterobacteria to the liver through the enterohepatic circulation. Moreover, in a population with metabolic syndrome, the interaction between periodontitis and systemic conditions related to insulin resistance further strengthens the association with nonalcoholic fatty liver disease. However, most of the pathologic links between periodontitis and nonalcoholic fatty liver disease in humans are provided by epidemiologic observational studies, with the causal relationship not yet being established. Several systematic and meta‐analysis studies also show conflicting results. In addition, the effect of periodontal treatment on nonalcoholic fatty liver disease has hardly been studied. Despite these limitations, the global burden of periodontal disease combined with the recent nonalcoholic fatty liver disease epidemic has important clinical and public health implications. Emerging evidence suggests an association between periodontal disease and liver diseases, and thus we propose the term periodontal disease–related nonalcoholic fatty liver disease or periodontal disease–related nonalcoholic steatohepatitis. Continued efforts in this area will pave the way for new diagnostic and therapeutic approaches based on a periodontologic viewpoint to address this life‐threatening liver disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan.,Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.,Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Satoshi Sekino
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yvonne Kapila
- Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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22
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Li A, Chen Y, Schuller AA, van der Sluis LWM, Tjakkes GHE. Dietary inflammatory potential is associated with poor periodontal health: A population-based study. J Clin Periodontol 2021; 48:907-918. [PMID: 33899265 PMCID: PMC8251843 DOI: 10.1111/jcpe.13472] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/18/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
Aim To investigate the association between dietary inflammatory potential and poor periodontal health. Material and Methods A cross‐sectional analysis of a nationally representative sample of participants was performed. NHANES 2011–2014 (n = 7081) and NHANES 2001–2004 (n = 5098) were used as discovery and validation datasets, respectively. The energy‐adjusted dietary inflammatory index (E‐DII) score was calculated for each participant based on 24‐h dietary recalls to assess diet‐associated inflammation. Periodontitis was defined by the CDC/AAP using clinical periodontal parameters. Natural cubic spline was applied to identify any non‐linear associations of the E‐DII score with moderate/severe periodontitis. Furthermore, interaction analyses were performed by age, gender, and race/ethnicity to explore the moderating roles of these factors. Results In the discovery dataset, a non‐linear positive relationship with periodontitis was identified for the E‐DII score (pnon‐linearity < .001) after adjustment for potential confounders. Compared with those individuals in the lowest tertile of E‐DII, participants in the highest tertile who consumed a pro‐inflammatory diet were 53% more likely to be periodontitis (OR tertile3vs1 = 1.53, 95% CI: 1.33–1.77). The validation dataset showed similar associations. Relatively stronger associations were seen in older adults and males. Conclusion Consuming a pro‐inflammatory diet indicated by the E‐DII score is associated with periodontal disease in the U.S. general adult population.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, UMCG, University of Groningen, Groningen, the Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.,Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Luc W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
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23
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Hatasa M, Yoshida S, Takahashi H, Tanaka K, Kubotsu Y, Ohsugi Y, Katagiri T, Iwata T, Katagiri S. Relationship between NAFLD and Periodontal Disease from the View of Clinical and Basic Research, and Immunological Response. Int J Mol Sci 2021; 22:3728. [PMID: 33918456 PMCID: PMC8038294 DOI: 10.3390/ijms22073728] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/22/2022] Open
Abstract
Periodontal disease is an inflammatory disease caused by pathogenic oral microorganisms that leads to the destruction of alveolar bone and connective tissues around the teeth. Although many studies have shown that periodontal disease is a risk factor for systemic diseases, such as type 2 diabetes and cardiovascular diseases, the relationship between nonalcoholic fatty liver disease (NAFLD) and periodontal disease has not yet been clarified. Thus, the purpose of this review was to reveal the relationship between NAFLD and periodontal disease based on epidemiological studies, basic research, and immunology. Many cross-sectional and prospective epidemiological studies have indicated that periodontal disease is a risk factor for NAFLD. An in vivo animal model revealed that infection with periodontopathic bacteria accelerates the progression of NAFLD accompanied by enhanced steatosis. Moreover, the detection of periodontopathic bacteria in the liver may demonstrate that the bacteria have a direct impact on NAFLD. Furthermore, Porphyromonas gingivalis lipopolysaccharide induces inflammation and accumulation of intracellular lipids in hepatocytes. Th17 may be a key molecule for explaining the relationship between periodontal disease and NAFLD. In this review, we attempted to establish that oral health is essential for systemic health, especially in patients with NAFLD.
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Affiliation(s)
- Masahiro Hatasa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (M.H.); (S.Y.); (Y.O.); (T.I.)
| | - Sumiko Yoshida
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (M.H.); (S.Y.); (Y.O.); (T.I.)
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (K.T.); (Y.K.)
- Liver Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Kenichi Tanaka
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (K.T.); (Y.K.)
| | - Yoshihito Kubotsu
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (K.T.); (Y.K.)
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (M.H.); (S.Y.); (Y.O.); (T.I.)
| | - Takaharu Katagiri
- Department of Biochemistry, Toho University School of Medicine, Tokyo 143-8540, Japan;
- Division of Rheumatology, Department of Internal Medicine, Ohashi Medical Center, Tokyo 153-8515, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (M.H.); (S.Y.); (Y.O.); (T.I.)
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (M.H.); (S.Y.); (Y.O.); (T.I.)
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24
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Hannan CJ, Ricks TL, Espinoza L, Weintraub JA. Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors. Prev Chronic Dis 2021; 18:E27. [PMID: 33769254 PMCID: PMC8021144 DOI: 10.5888/pcd18.210060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Casey J Hannan
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-8, Atlanta, GA.
| | - Timothy L Ricks
- US Public Health Service, Indian Health Service Headquarters, Division of Oral Health, Rockville, Maryland
| | - Lorena Espinoza
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jane A Weintraub
- University of North Carolina at Chapel Hill, Adams School of Dentistry and Gillings School of Global Public Health, Chapel Hill, North Carolina
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25
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Luo C, Sun H, Peng J, Gao C, Bao L, Ji R, Zhang C, Zhu W, Jin Y. Rosmarinic acid exerts an antagonistic effect on nonalcoholic fatty liver disease by regulating the YAP1/TAZ-PPARγ/PGC-1α signaling pathway. Phytother Res 2021; 35:1010-1022. [PMID: 32914480 DOI: 10.1002/ptr.6865] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/31/2020] [Accepted: 08/16/2020] [Indexed: 02/06/2023]
Abstract
Rosmarinic acid (RA) is a water-soluble phenolic compound extracted from Boraginaceae and Lamiaceae. This study was designed to investigate the role and mechanism of action of RA in improving nonalcoholic fatty liver disease (NAFLD). Male SD rats maintained on a high fat diet and L02 cells stimulated with oleic acid were treated with RA. Our results showed that RA significantly reduced total cholesterol, triglycerides, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and malondialdehyde levels and increased high-density lipoprotein cholesterol, superoxide dismutase and adenosine triphosphate levels both in vivo and in vitro. Hematoxylin and eosin staining and oil red O staining showed that RA had a good lipid-lowering effect and substantial protective effects on liver injury. Transmission electron microscopy and JC-1 fluorescence results showed that RA could improve mitochondrial damage in hepatocytes. Additionally, flow cytometry results indicated that RA inhibited ROS generation and apoptosis in L02 cells. The impaired hepatocytes were restored by using RA in NAFLD models characterized by down-regulating YAP1 and TAZ, meanwhile up-regulating PPARγ and PGC-1α. When YAP1 was over-expressed, RA reduced the expression of YAP1; however, the action of RA was significantly blocked by silencing YAP1. The experimental results indicated that RA markedly alleviated NAFLD by repairing mitochondrial damage and regulating the YAP1/TAZ-PPARγ/PGC-1α signaling pathway.
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Affiliation(s)
- Chunxu Luo
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Huijun Sun
- College of Pharmacy, Dalian Medical University, Dalian, China
- Key Laboratory for Basic and Applied Research on Pharmacodynamic Substances of Traditional Chinese Medicine of Liaoning Province, Dalian Medical University, Dalian, China
| | - Jinyong Peng
- College of Pharmacy, Dalian Medical University, Dalian, China
- Key Laboratory for Basic and Applied Research on Pharmacodynamic Substances of Traditional Chinese Medicine of Liaoning Province, Dalian Medical University, Dalian, China
| | - Cong Gao
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Liuchi Bao
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Renpeng Ji
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Chi Zhang
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Wenhan Zhu
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Yue Jin
- College of Pharmacy, Dalian Medical University, Dalian, China
- Key Laboratory for Basic and Applied Research on Pharmacodynamic Substances of Traditional Chinese Medicine of Liaoning Province, Dalian Medical University, Dalian, China
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26
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Al-Maweri SA, Ibraheem WI, Al-Ak'hali MS, Shamala A, Halboub E, Alhajj MN. Association of periodontitis and tooth loss with liver cancer: A systematic review. Crit Rev Oncol Hematol 2021; 159:103221. [PMID: 33482347 DOI: 10.1016/j.critrevonc.2021.103221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 02/08/2023] Open
Abstract
A number of epidemiological studies have suggested a positive association between periodontal diseases and oro-digestive cancers, including liver cancer. The purpose of the present systematic review was to analyze the current evidence regarding the potential association between periodontitis and/or tooth loss and the risk of liver cancer. A comprehensive search of PubMed, Scopus and Web of Science databases was conducted in August 2019. The inclusion criteria comprised all observational studies that assessed the relationship between periodontitis or tooth loss and liver cancer. Case reports, animal studies, experimental studies, and reviews were excluded. Due to great heterogeneity among the included studies, no meta-analysis was conducted. Six studies (five prospective cohorts and one case-control) comprising 619,834 subjects (including 916 liver cancer cases) were included. The studies were conducted in the United States, Europe, and Asia. Three large-scale cohort studies reported a positive association between periodontitis or tooth loss and the risk of liver cancer. One case-control study found some association between liver cancer and loss of 12-23 teeth, but such association was not replicated in patients with greater number of tooth loss. Contrarily, two studies failed to report any association between periodontitis and/or tooth loss and the risk of liver cancer. The available evidence suggests a possible link between tooth loss/periodontitis and the risk of liver cancer. However, the evidence is not conclusive enough, a fact that drives to conduct more, well-designed, prospective cohort studies to further explore the potential association between periodontitis and the risk of liver cancer.
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Affiliation(s)
- Sadeq Ali Al-Maweri
- Department of Oral Medicine and Diagnostic Sciences, AlFarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen.
| | - Wael Ibraheem Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia.
| | - Mohammad Sultan Al-Ak'hali
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia; Department of Periodontology, Faculty of Dentistry, Sana'a University, Yemen.
| | - Anas Shamala
- Department of Biological and Preventive Sciences, College of Dentistry, University of Sciences and Technology, Sana'a, Yemen.
| | - Esam Halboub
- Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen; Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Saudi Arabia.
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27
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Shah PD, Badner VM. Association between asthma and severe tooth loss in the adult population of the United States. J Asthma 2020; 59:462-468. [PMID: 33356681 DOI: 10.1080/02770903.2020.1856868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between asthma and severe tooth loss in the U.S. (United States) adult population. METHODS Data were analyzed from the national health and nutritional examination survey (NHANES), 2009-2014. Study-participants were classified into current, former, and never asthmatics based on their asthma status. Former-asthmatics were excluded. The case definition of severe tooth loss (outcome variable) was having 9 or fewer remaining permanent teeth. Characteristics of our study-sample were identified based on the descriptive statistical analyses. Logistic regression analyses were performed to examine the association between asthma and severe tooth. Multivariable models were constructed to control for the known common clinical, demographic, and lifestyle factors. Each analysis accounted for the examination sample weights and the complex clustered design of the continuous NHANES. RESULTS Total study-participants were 14,184 representing ≈185.77 million U.S. adults. Prevalence of asthma was 8.99% in our study-sample, and 8.78% had severe tooth loss. Current-asthmatic adults had 34% higher odds of severe tooth loss as compared to their reference group of never-asthmatics adults in the U.S. after controlling for age, race or ethnicity, gender, diabetes, smoking, body mass index, education, and family income-to-poverty ratio. CONCLUSION In the United States, as compared to never-asthmatic adults, current-asthmatic adults were more likely to have severe tooth-loss. Oral health promotion is therefore recommended through medical-dental integration to ensure overall health for asthmatic adults.
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Affiliation(s)
- Parth D Shah
- Division of Population Health and Community Dentistry, Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, NY, USA
| | - Victor M Badner
- Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, NY, USA
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28
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Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses 2020; 144:109969. [PMID: 32592918 PMCID: PMC7303044 DOI: 10.1016/j.mehy.2020.109969] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.
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Affiliation(s)
- Viviana Pitones-Rubio
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - E G Chávez-Cortez
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Angélica Hurtado-Camarena
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Anna González-Rascón
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Nicolás Serafín-Higuera
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico.
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29
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Chen Y, Yang YC, Zhu BL, Wu CC, Lin RF, Zhang X. Association between periodontal disease, tooth loss and liver diseases risk. J Clin Periodontol 2020; 47:1053-1063. [PMID: 32621350 DOI: 10.1111/jcpe.13341] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/13/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022]
Abstract
AIM The purpose of this study is to assess the associations between periodontal disease, tooth loss and liver diseases. MATERIALS AND METHODS PubMed and Embase databases were utilized to search eligible studies. Odds ratio (OR) with 95% confidence interval (CI) was used as effect size to assess the associations between periodontal disease, tooth loss and liver diseases risk. RESULTS Our results indicated positive associations between periodontal disease and non-alcoholic fatty liver disease (NAFLD) (OR = 1.19, 95% CI = 1.06-1.33), liver cirrhosis (OR = 2.28, 95% CI = 1.50-3.48) and elevated transaminase level risk (OR = 1.08, 95% CI = 1.02-1.15). Moreover, tooth loss could increase NAFLD (OR = 1.33, 95% CI = 1.12- 1.56) and liver cancer risk (OR = 1.34, 95% CI = 1.04-1.74), and every five increment in tooth loss was associated with 5% increased liver cancer risk (OR = 1.05, 95% CI = 1.01 - 1.10) with a linear relationship. In addition, tooth loss had a positive tendency towards liver cirrhosis risk (OR = 2.03, 95% CI = 0.85-4.85) although there was no statistical significance. CONCLUSION Periodontal disease and tooth loss are positively associated with liver diseases including NAFLD, elevated transaminase level, liver cirrhosis and liver cancer.
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Affiliation(s)
- You Chen
- College of Stomatology, Dalian Medical University, Dalian City, China
| | - Yu-Chong Yang
- National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin, China
| | - Bao-Ling Zhu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Cong-Cong Wu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Rui-Fang Lin
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, China
| | - Xi Zhang
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, China
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