Periodontitis is associated with incident chronic liver disease—A population‐based cohort study
Tóm tắt
Chronic liver disease is a major health concern worldwide and the identification of novel modifiable risk factors may benefit subjects at risk. Few studies have analyzed periodontitis as a risk factor for liver complications. We studied whether periodontitis is associated with incident severe liver disease.
The study comprised 6165 individuals without baseline liver disease who participated in the Finnish population‐based Health 2000 Survey (BRIF8901) during 2000‐2001, a nationally representative cohort. Follow‐up was until 2013 for liver‐related admissions, liver cancer and mortality from National Hospital Discharge, Finnish Cancer Registry and Causes of Death Register, Statistics Finland. Mild to moderate periodontitis was defined as ≥1 tooth with periodontal pocket ≥4 mm deep, and advanced periodontitis as ≥5 teeth with such pockets. Multiple confounders were considered.
A total of 79 subjects experienced a severe liver event during follow‐up. When adjusted for age, sex and number of teeth, hazards ratios by Cox regression regarding incident severe liver disease were, for mild to moderate periodontitis, 2.12 (95% CI 0.98‐4.58), and, for advanced periodontitis, 3.69 (95% CI 1.79‐7.60). These risk estimates remained stable after additionally adjusting for alcohol use, smoking, metabolic risk, serum gamma‐glutamyltransferase, dental‐care habits, lifestyle and socioeconomic status. Periodontal disease‐associated liver risk was accentuated among subjects with non‐alcoholic fatty liver disease or heavy alcohol use at baseline.
Periodontitis was associated with incident liver disease in the general population independently of various confounders. As a preventable disease, periodontal disease might present a modifiable risk factor for chronic liver disease.
Từ khóa
Tài liệu tham khảo
Suominen‐Taipale L, 2008, Oral Health in the Finnish Adult Population. Health 2000 Survey
Demmer RT, 2000, Epidemiologic patterns of chronic and aggressive periodontitis, Periodontol, 2010, 28
World Health Organization.Oral Health Key facts.http://www.who.int/news-room/fact-sheets/detail/oral-health. Accessed October 15 2018.
Ilievski V, 2016, Experimental periodontitis results in prediabetes and metabolic alterations in brain, liver and heart: global untargeted metabolomic analyses, J Oral Biol (Northborough), 3, 1
Aromaa A, 2004, Health and Functional Capacity in Finland. Baseline Results of the Health 2000 Health Examination Survey
Heistaro S, Methodology Report. Health 2000 Survey
Kelly M, 2000, Adult Dental Health Survey: Oral Health in the United Kingdom 1998
WHO, 1997, Oral health surveys. Basic methods