Periodontitis is associated with incident chronic liver disease—A population‐based cohort study

Liver International - Tập 39 Số 3 - Trang 583-591 - 2019
Jaana Helenius‐Hietala1, Anna Liisa Suominen2,3,4, Hellevi Ruokonen1, Matti Knuuttila5, Pauli Puukka6, Antti Jula6, Jukka H. Meurman1, Fredrik Åberg7,8
1Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
3Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
4Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
5Medical Research Center Oulu, University Hospital and University of Oulu, Oulu, Finland
6Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
7The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
8Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Tóm tắt

AbstractBackground & AimsChronic 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.MethodsThe 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.ResultsA 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.ConclusionsPeriodontitis 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.

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Liver International

Tập 39 Số 3

583-591

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