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The potential association between periodontitis and non-alcoholic fatty liver disease: a systematic review

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Abstract

Objectives

Many animal and human studies have shown associations between periodontitis and non-alcoholic fatty liver disease (NAFLD). Hence, the present systematic review sought to investigate such a potential association.

Methods

PubMed/Medline, Scopus, Embase, and Web of Science databases were thoroughly searched to identify all relevant studies. The eligibility criteria were all observational (cross-sectional studies, case-control, cohort studies, and case reports) and interventional studies that assessed the relationship between periodontitis and NAFLD in humans. Due to remarkable heterogeneity and inconsistency among the included studies, no statistical analyses were conducted.

Results

A total of 12 studies comprising 53,384 patients were included in the present systematic review. The sample size in the individual studies ranged from 52 to 24,470 patients. All studies except one found significant associations between clinical and/or microbial periodontal parameters and NAFLD. Eight studies found significant associations between clinical periodontal parameters and NAFLD. Four microbial studies found a significant association between periodontal pathogens, especially Porphyromonas gingivalis and NAFLD development and progression.

Conclusions

The available evidence suggests that periodontitis may be a risk factor for development and progression of NAFLD. However, due to limited number of prospective cohort studies included in this review along with the substantial heterogeneity among the included studies, further well-designed prospective cohort studies are highly warranted.

Clinical relevance

Given the potential association between periodontitis and NAFLD, it can be assumed that healthy periodontium may be essential for liver health.

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Authors and Affiliations

  1. Department of Preventive Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia

    Mohammad Sultan Alakhali

  2. Department of Periodontology, College of Dentistry, Sanaa University, Sanaa, Yemen

    Mohammad Sultan Alakhali

  3. Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges for Dentistry and Nursing, Riyadh, Saudi Arabia

    Sadeq Ali Al-Maweri

  4. Department of Oral and Maxillofacial Surgery, AlFarabi Colleges for Dentistry and Nursing, Riyadh, Saudi Arabia

    Hashem Motahir Al-Shamiri

  5. Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Sana’a University, Sana’a, Yemen

    Khaled Al-haddad

  6. Department of Maxillofacial Surgery and Diagnostic sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia

    Esam Halboub

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  1. Mohammad Sultan Alakhali
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Alakhali, M.S., Al-Maweri, S.A., Al-Shamiri, H.M. et al. The potential association between periodontitis and non-alcoholic fatty liver disease: a systematic review. Clin Oral Invest 22, 2965–2974 (2018). https://doi.org/10.1007/s00784-018-2726-1

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