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

Abstract

BackgroundThe 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 MethodsJapanese 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.ResultsAfter 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.ConclusionsThere 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.

Periodontal disease–related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral‐liver axis

“…Kuroki et al 41 recently studied the relationship between the levels of serum biomarkers (aspartate aminotransferase, alanine aminotransferase, and gamma‐glutamyl transpeptidase) and alveolar bone (assessed from panoramic radiographs) in 110 residents (mean age 73.3 years) on a Japanese island. Participants were divided into quartiles according to individual values of alveolar bone loss.…”

“… 21 , 22 , 23 Related to this, the concept of a gut‐liver axis and gut dysbiosis was further proposed as another potential route linking the oral cavity and the liver. 24 , 25 Since the late 2010s, systematic reviews and meta‐analyses 26 , 27 , 28 have continued to report on these associations based on growing evidence from epidemiologic studies 21 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 and on additional evaluation from in vivo research. 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 Moreover, as a next step, clinical studies with therapeutic intervention are expected to verify the effect of periodontal treatment on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.…”

Periodontitis and non-alcoholic fatty liver disease: a Mendelian randomisation analysis

“…A cross-sectional study of Hispanics/Latinos reported no correlation between the prevalence of NAFLD and the clinical parameters of PD(16). Furthermore, a cross-sectional study of Japanese adults reported no correlation between PD and the biochemical parameters of NAFLD (35). Although there have been meta-analyses on the association between PD and NAFLD, they have contradictory ndings (15,36,37).…”

Association Between Pre-Transplant Oral Health and Post-Liver Transplant Complications

“…Previous publications on the association between liver enzymes and oral health are contradictory and are mainly focused on periodontitis. Some studies show no association between liver enzyme values and alveolar bone loss in patients without liver disease [31,32], while other studies show higher liver enzyme levels in patients with periodontitis [33,34]. Some studies hypothesize that periodontal disease might be a risk factor for the development of non-alcoholic steatohepatitis [35][36][37] and chronic liver disease [38].…”