Association between nonalcoholic fatty liver disease and inflammatory periodontal disease: A case‑control study

Ajay Duseja; Gurparkash Singh Chahal; Ashish Jain; Manu Mehta; Aditya Ranjan; Vishakha Grover

doi:10.4103/jisp.jisp_45_20

Association between nonalcoholic fatty liver disease and inflammatory periodontal disease: A case‑control study

J Indian Soc Periodontol. 2021 Jan-Feb;25(1):47-54. doi: 10.4103/jisp.jisp_45_20. Epub 2020 Sep 21.

Authors

Ajay Duseja¹, Gurparkash Singh Chahal², Ashish Jain², Manu Mehta¹, Aditya Ranjan², Vishakha Grover²

Affiliations

¹ Department of Hepatology, PGIMER, Panjab University, Chandigarh, India.
² Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India.

Abstract

Background: Recent evidence suggests an interconnection between chronic periodontal disease and systemic diseases.

Aim: The aim of this study is to evaluate the possible association between nonalcoholic fatty liver disease (NAFLD) and inflammatory periodontal disease among north Indian population.

Settings and design: Tertiary health care center, cross-sectional case-control observational study.

Materials and methods: A total of 40 cases, i.e., patients with NAFLD and 40 healthy volunteers were included over a period of 8 months and their periodontal status was compared. The status of their hepatic health was ascertained by anthropometric, imaging, and biochemical evaluation including ultrasound examination of abdomen and transient elastography.

Statistical data analysis: Paired t-test, multivariate logistic regression analysis using IBM SPSS STATISTICS (version 22.0, Armonk, NY: IBM Corp).

Results: The study revealed that only 11.9% and 20% of participants had periodontitis, in healthy controls and hepatic disease patients, respectively. A statistically significant difference was observed in clinical parameters of periodontal status, except for malocclusion. Comparative analysis of tumor necrosis factor-α (TNF-α), interleukin-6, C-reactive protein, and cytokeratin-18 revealed differences in mean scores, though statistically nonsignificant. Only aspartate transaminase, number of missing teeth, and bleeding on probing (BOP) were observed with higher odds ratios for hepatic disease patients. Spearman correlation analysis revealed significant positive correlations between TNF-α and BOP, for cases.

Conclusion: Patients with hepatic disease showed a higher prevalence of periodontal disease, worse oral hygiene and periodontal health status compared to healthy individuals.

Keywords: Bleeding on probing; case control; nonalcoholic fatty liver disease; oral health; periodontal disease; systemic health; tumor necrosis factor.