Effect of periodontal basic treatment on liver function and lipid levels in periodontitis patients with non-alcoholic fatty liver disease
-
摘要:
目的 评估牙周基础治疗对非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)伴牙周炎患者肝功能及血脂的影响。 方法 选择2018年7月—2019年6月杭州师范大学附属医院牙周科就诊的30例NAFLD伴中重度牙周炎患者，对入组患者进行牙周基础治疗，在治疗前和治疗后3个月分别对牙周临床指标、肝功能水平及血脂进行检测，治疗前后的数据对比采用配对t检验。 结果 与牙周基础治疗前相比，治疗后3个月牙周探诊深度从(3.76±0.46)mm下降至(2.30±0.37)mm，临床附着水平从(4.90±0.48)mm下降至(3.90±0.49)mm，全口探诊出血位点百分比从(88.93±5.05)%下降至(20.47±5.98)%；同时，丙氨酸氨基转移酶从(61.60±12.07)U/L下降至(45.82±11.82)U/L，天冬氨酸氨基转移酶从(54.71±11.20)U/L下降至(44.87±11.36)U/L；此外，总胆固醇从(5.63±0.24)mmol/L降低为(5.23±0.24)mmol/L，三酰甘油从(1.90±0.10)mmol/L下降至(1.63±0.13)mmol/L，低密度脂蛋白从(2.78±0.30)mmol/L降至(1.78±0.43)mmol/L，高密度脂蛋白从(1.25±0.05)mmol/L升高至(1.39±0.06)mmol/L，治疗前后差异均有统计学意义(均P＜0.001)。 结论 NAFLD伴牙周炎患者经过牙周基础治疗可获得良好的临床疗效，不仅牙周状态明显好转，同时也改善了患者的肝功能和血脂水平，牙周基础治疗可能是NAFLD伴牙周炎患者的治疗管理途径之一。 Abstract:Objective To evaluate the effects of periodontal basic treatment on liver function and lipid levels in periodontitis patients with non-alcoholic fatty liver disease (NAFLD). Methods Thirty moderate or severe periodontitis cases with NAFLD were selected from July 2018 to June 2019 in Department of Periodontics, Affiliated Hospital of Hangzhou Normal University. All enrolled patients were treated with periodontal basic treatment. Periodontal clinical index, lipid levels and liver function examination were determined at baseline and 3 months after treatment. Paired t test was used to compare the data. Results Compared with periodontal basic treatment, the periodontal probing depth decreased from (3.76±0.46) mm to (2.30±0.37) mm, the clinical attachment level decreased from (4.90±0.48) mm to (3.90±0.49) mm, and the percentage of bleeding on probing decreased from (88.93±5.05) % to (20.47±5.98) %. Meanwhile, the alanine aminotransferase decreased from (61.60±12.07) U/L to (45.82±11.82) U/L, and the aspartate aminotransferase decreased from (54.71±11.20) U/L to (44.87±11.36) U/L. In addition, total cholesterol reduced from (5.63±0.24) mmol/L to (5.23±0.24) mmol/L, triacylglycerol decreased from (1.90±0.10) mmol/L to (1.63±0.13) mmol/L, low-density lipoprotein decreased from (2.78±0.30) mmol/L to (1.78±0.43) mmol/L, and high-density lipoprotein increased from (1.25±0.05) mmol/L to (1.39±0.06) mmol/L. Conclusion Periodontitis patients with NAFLD can obtain good clinical efficacy through periodontal basic treatment, which not only significantly improves their periodontal status, but also improves their liver function and blood lipid level. Therefore, periodontal basic treatment may be one of the treatment approaches for periodontitis patients with NAFLD. -
表 1 NAFLD伴中重度牙周炎患者治疗前和治疗后3个月牙周临床指标比较(x ±s)
时间 PD(mm) CAL(mm) BOP(%) 治疗前 3.76±0.46 4.90±0.48 88.93±5.05 治疗后3个月 2.30±0.37 3.90±0.49 20.47±5.98 t值 63.490 100.520 108.652 P值 ＜0.001 ＜0.001 ＜0.001 
下载: 导出CSV
表 2 NAFLD伴中重度牙周炎患者治疗前和治疗后3个月肝功能比较(x ±s，U/L)
时间 ALT AST 治疗前 61.60±12.07 54.71±11.20 治疗后3个月 45.82±11.82 44.87±11.36 t值 36.549 23.844 P值 ＜0.001 ＜0.001
下载: 导出CSV
表 3 NAFLD伴中重度牙周炎患者治疗前和治疗后3个月血脂水平比较(x ±s，mmol/L)
时间 TC TG LDL HDL 治疗前 5.63±0.24 1.90±0.10 2.78±0.30 1.25±0.05 治疗后3个月 5.23±0.24 1.63±0.13 1.78±0.43 1.39±0.06 t值 43.922 22.484 17.882 38.095 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001
下载: 导出CSV
-
[1] SLOTS J. Periodontitis: Facts, fallacies and the future[J]. Periodontol 2000, 2017, 75(1): 7-23. doi: 10.1111/prd.12221 [2] KINANE D F, STATHOPOULOU P G, PAPAPANOU P N. Periodontal diseases[J]. Nat Rev Dis Primers, 2017, 3: 17038. DOI: 10.1038/nrdp.2017.38. [3] HEOZOR-EJIOFOR Z, MIDDLETON P, ESPOSITO M, et al. Treating periodontal disease for preventing adverse birth outcomes in pregnant women[J]. Cochrane Database Syst Rev, 2017, 6(6): CD005297. DOI: 10.1002/14651858.CD005297.pub3. [4] SCZEPANIK F S C, GROSSI M L, CASATI M, et al. Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way[J]. Periodontol 2000, 2020, 84(1): 45-68. doi: 10.1111/prd.12342 [5] YANG B, PETRICK J L, ABNET C C, et al. Tooth loss and liver cancer incidence in a Finnish cohort[J]. Cancer Cause Control, 2017, 28(8): 899-904. doi: 10.1007/s10552-017-0906-y [6] KHAN R S, NEWSOME P N. NAFLD in 2017: Novel insights into mechanisms of disease progression[J]. Nat Rev Gastroenterol Hepatol, 2018, 15(2): 71-72. doi: 10.1038/nrgastro.2017.181 [7] WEINTRAUB J A, LOPEZ MITNIK G, DYE B A. Oral diseases associated with nonalcoholic fatty liver disease in the United States[J]. J Dent Res, 2019, 98(11): 1219-1226. doi: 10.1177/0022034519866442 [8] HAN P, SUN D, YANG J. Interaction between periodontitis and liver diseases[J]. Biomed Rep, 2016, 5(3): 267-276. doi: 10.3892/br.2016.718 [9] CHEN Y, YANG Y C, ZHU B L, et al. Association between periodontal disease, tooth loss and liver diseases risk[J]. J Clin Periodontol, 2020, 47(9): 1053-1063. doi: 10.1111/jcpe.13341 [10] 吴小翠, 李富强, 唐翠兰. 非酒精性脂肪性肝病的诊断学进展[J]. 浙江临床医学, 2016, 18(4): 764-765. https://www.cnki.com.cn/Article/CJFDTOTAL-WCBX201710002.htm [11] ARMITAGE G C. Development of a classification system for periodontal diseases and conditions[J]. Northwest Dent, 2000, 79(6): 31-35. [12] WIJARNPREECHA K, PANJAWATANAN P, CHEUNGPASITPORN W, et al. The association between periodontitis and nonalcoholic fatty liver disease: A systematic review and meta-analysis[J]. J Gastrointestin Liver Dis, 2020, 29(2): 211-217. doi: 10.15403/jgld-841 [13] GRONKJAER L L. Periodontal disease and liver cirrhosis: A systematic review[J]. SAGE Open Med, 2015, 3: 2050312115601122. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.988.8995&rep=rep1&type=pdf [14] FURUTA M, EKUNI D, YAMAMOTO T, et al. Relationship between periodontitis and hepatic abnormalities in young adults[J]. Acta Odontol Scand, 2010, 68(1): 27-33. doi: 10.3109/00016350903291913 [15] MORITA T, YAMAZAKI Y, FUJIHARU C, et al. Serum gamma-glutamyltransferase level is associated with periodontal disease independent of drinking habits in Japanese adults[J]. Med Sci Monit, 2014, 20: 2109-2116. doi: 10.12659/MSM.891204 [16] YONEDA M, NAKA S, NAKANO K, et al. Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease[J]. BMC Gastroenterol, 2012, 12: 16. doi: 10.1186/1471-230X-12-16 [17] AKINKUGBE A A, BARRITT A S, CAI J, et al. Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos[J]. J Periodontol, 2018, 89(8): 949-958. doi: 10.1002/JPER.17-0579 [18] WIDITA E, YOSHIHARA A, HANINDRIYO L, et al. Relationship between clinical periodontal parameters and changes in liver enzymes levels over an 8-year period in an elderly Japanese population[J]. J Clin Periodontol, 2018, 45(3): 311-321. doi: 10.1111/jcpe.12861 [19] AKINKUGBE A A, SLADE G D, BARRITT A S, et al. Periodontitis and non-alcoholic fatty liver disease, a population-based cohort investigation in the study of health in pomerania[J]. J Clin Periodontol, 2017, 44(11): 1077-1087. doi: 10.1111/jcpe.12800 [20] NAKAHARA T, HYOGO H, ONO A, et al. Involvement of porphyromonas gingivalis in the progression of non-alcoholic fatty liver disease[J]. J Gastroenterol, 2017, 53(2): 269-280. http://download.xuebalib.com/xuebalib.com.39814.pdf [21] KOMAZAKI R, KATAGIRI S, TAKAHASHI H, et al. Periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans affect non-alcoholic fatty liver disease by altering gut microbiota and glucose metabolism[J]. Sci Rep, 2017, 7(1): 13950. doi: 10.1038/s41598-017-14260-9 [22] KUMAR J, TEOH S L, DAS S, et al. Oxidative stress in oral diseases: understanding its relation with other systemic diseases[J]. Front Physiol, 2017, 8: 693. doi: 10.3389/fphys.2017.00693 [23] VASCONCELOS D F, PEREIRA DA SILVA F R, PINTO M E, et al. Decrease of pericytes is associated with liver disease caused by ligature-induced periodontitis in rats[J]. J Periodontol, 2017, 88(2): e49-e57. doi: 10.1902/jop.2016.160392 [24] DOS SANTOS CARVALHO J, CARDOSO GUIMARÃES VASCONCELOS A C, HERLANY PEREIRA ALVES E, et al. Steatosis caused by experimental periodontitis is reversible after removal of ligature in rats[J]. J Periodontal Res, 2017, 52(5): 883-892. doi: 10.1111/jre.12459 -
点击查看大图
表(3)
计量
- 文章访问数: 121
- HTML全文浏览量: 57
- PDF下载量: 2
- 被引次数: 0
