Association of liver enzyme levels and alveolar bone loss: A cross-sectional clinical study in Sado Island

Ayumi Kuroki; Noriko Sugita; Shigeki Komatsu; Akio Yokoseki; Akihiro Yoshihara; Tetsuo Kobayashi; Kazutoshi Nakamura; Takeshi Momotsu; Naoto Endo; Kenji Sato; Ichiei Narita; Hiromasa Yoshie

doi:10.4317/jced.54555

Association of liver enzyme levels and alveolar bone loss: A cross-sectional clinical study in Sado Island

J Clin Exp Dent. 2018 Feb 1;10(2):e100-e106. doi: 10.4317/jced.54555. eCollection 2018 Feb.

Authors

Affiliations

¹ DDS, Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
² Assistant Professor, DDS, PhD, Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
³ DDS, PhD, Sado General Hospital, Niigata, Japan.
⁴ Specially appointed Associate Professor, MD, PhD, Department of Molecular Neuroscience, Resource Branch for Brain Disease Research, Brain Research Institute, Niigata, Japan.
⁵ Professor, DDS, PhD, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁶ Associate Professor, DDS, PhD, General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital, Niigata, Japan.
⁷ Professor, MD, PhD, Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
⁸ MD, PhD, Sado General Hospital, Niigata, Japan.
⁹ Professor, MD, PhD, Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
¹⁰ Professor, MD, PhD, Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
¹¹ Professor, DDS, PhD, Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Abstract

Background: The interaction of periodontopathic bacteria with host immune system induces the production of inflammatory mediators which leads to alveolar bone loss (ABL), the essential feature of periodontitis. Concurrently, periodontal diseases cause the elevation of blood cytokine levels, the alteration of gut microbiota and the dissemination of enterobacteria to the liver. Owing to these mechanisms, periodontal disease might be a risk for liver dysfunction. Several epidemiological studies have reported associations between periodontal diseases and liver dysfunction, although the association between ABL and liver dysfunction has not been investigated. This cross-sectional study determined if elevated serum liver enzyme levels were associated with ABL in Japanese adults.

Material and methods: Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in the study. Participants over 40 years of age who underwent dental panoramic radiography and blood tests were included. Drinking and smoking habits were self-administered. After excluding patients with edentulous jaw, diagnosed liver diseases, and those on dialysis, data from 44 men and 66 women with a mean age of 73 years were analyzed. The average percentage of ABL for each participant was calculated for mesial and distal sites of all remaining teeth. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were determined. Univariate analyses were performed to select covariates to be put in multivariate analyses. The association between elevated serum liver enzyme levels and the highest quartile of ABL were assessed by multiple logistic regression analysis.

Results: After adjusting for covariates, no significant association was found between elevated serum AST, ALT, or GGT levels as dependent variables and the highest quartile of ABL as an explanatory variable.

Conclusions: There was no significant association between the elevation of serum liver enzyme levels and ABL in Japanese adults. Key words:Liver enzymes, dental panoramic radiography, alveolar bone loss, Japanese adults.