Relationship between non-alcoholic fatty liver disease and periodontal disease: a review and study protocol on the effect of periodontal treatment on non-alcoholic fatty liver disease-猫眼课题宝

DOI：

10.15761/jts.1000160

发表时间：

2016

期刊：

影响因子：

通讯作者：

中科院分区：

其他

文献类型：

作者：

Chieko Kudo;Takaomi Kessoku;Yohei Kamata;Koichi Hidaka;Takeo Kurihashi;T. Iwasaki;S. Takashiba;T. Kodama;T. Tamura;A. Nakajima;M. Minabe

非酒精性脂肪性肝病（NAFLD）是一种世界性的慢性肝病。非酒精性脂肪性肝炎（NASH）是NAFLD的一种晚期形式，具有从肝脏炎症和纤维化进展为肝硬化和肝细胞癌的风险。NAFLD的病理机制已被提出，如双重打击假说和多重平行打击假说。牙周病是一种牙齿周围组织的慢性传染病，会导致牙齿脱落。一些报道表明牙周感染与NAFLD有关。NAFLD和牙周病是慢性炎症性疾病，被称为“无声疾病”。因此，这两种情况都需要及早发现，并在医疗和牙科护理的合作下进行治疗，以防止进展为NASH。为此，有必要在人类中进一步研究NAFLD与牙周病的关系以及牙周治疗对NAFLD的影响。本文就NAFLD与牙周病关系的研究进展进行综述，并介绍牙周治疗对NAFLD疗效的临床研究。近年来有几项研究报道了全身性疾病与牙周病的关系[1,2]。据报道，慢性牙周病与糖尿病（DM）、动脉粥样硬化和心脏病等疾病有关[3-6]。我们以前报道过牙周病原体感染与动脉粥样硬化的进展有关。脂肪性肝病是动脉粥样硬化的病因之一[8,9]，包括非酒精性脂肪性肝病（NAFLD）和酒精性脂肪性肝病（AFLD）[10]。NAFLD（无饮酒史或免疫系统疾病的肝脏脂肪堆积）已引起全世界的关注。NAFLD包括单纯性脂肪变性和非酒精性脂肪性肝炎（NASH），其特征是慢性和进行性肝脏病理[11]。美国普通成年人中NAFLD的患病率为10%-40%，NASH的患病率约为2%-5%。最近的动物和人类研究表明，NAFLD/NASH与牙周病有关[13,14]。由于肝病或牙周病患者主观症状和早期症状较少，在医疗机构发现时往往病情严重。(15、16)。因此，在医疗和牙科护理的协同下，早期发现和治疗对于防止进展为NASH至关重要，NASH可能随后发展为肝硬化或肝癌。需要进一步研究NAFLD与牙周病之间的关系以及牙周治疗对NAFLD的影响。通讯作者：工藤千子博士，DDS，博士，口腔功能与修复系牙周病科讲师，神奈川牙科大学牙科研究生院，日本神奈川横须贺市猪冈町82号，238-8580，电话：+81-46-822-8855；电子邮件:kudo@kdu.ac.jp

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that is prevalent worldwide. Non-alcoholic steatohepatitis (NASH) is an advanced form of NAFLD and carries the risk of progression from hepatic inflammation and fibrosis to cirrhosis and hepatocellular carcinoma. Pathological mechanisms of NAFLD have been proposed, such as the two-hit hypothesis and the multiple parallel hit hypothesis. Periodontal disease is a chronic infectious disease of the tissues surrounding the teeth that result in tooth loss. Several reports have indicated that periodontal infection is related to NAFLD. NAFLD and periodontal disease are chronic inflammatory conditions that are known as ‘silent diseases’. Therefore, both conditions need to be detected early and treated under collaborative medical and dental care in order to prevent progression to NASH. For this purpose, further investigations in humans on the relationship between NAFLD and periodontal disease and on the effect of periodontal treatment on NAFLD are necessary. In this paper, studies on the relationship between NAFLD and periodontal disease are reviewed and a clinical study investigating the effect of periodontal treatment on NAFLD is introduced. Introduction Several studies in recent years have reported on the relationship between systemic disease and periodontal disease [1,2]. It has been reported that chronic periodontal disease is related to conditions, such as diabetes mellitus (DM), atherosclerosis and heart disease [3-6]. We have previously reported that infection with periodontal pathogens is associated with the progression of atherosclerosis [7]. Fatty liver disease, which is one of the causes of atherosclerosis [8,9], includes non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) [10]. NAFLD (in which fat accumulates in the liver without a history of drinking or immune system disease) has gained attention worldwide. NAFLD includes simple steatosis and nonalcoholic steatohepatitis (NASH), which is characterized by a chronic and progressive liver pathology [11]. The prevalence of NAFLD in the American general adult population is 10%-40% and that of NASH is approximately 2%-5% [12]. Recent animal and human investigations have indicated that NAFLD/NASH is related to periodontal disease [13,14]. As patients with liver or periodontal disease have few subjective and early symptoms, the diseases are often severe when they are discovered at medical institutions. [15,16]. Therefore, early detection and treatment under collaborative medical and dental care is important to prevent progression to NASH, which may then develop into cirrhosis or liver cancer. Further investigations in humans on the relationship between NAFLD and periodontal disease and on the effect of periodontal treatment on NAFLD are desired. This paper reviews studies on NAFLD and periodontal *Correspondence to: Dr. Chieko Kudo, DDS, PhD, Lecturer, Division of Periodontology, Department of Oral Function and Restoration, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan, Tel: +81-46-822-8855; E-mail: kudo@kdu.ac.jp

Relationship between non-alcoholic fatty liver disease and periodontal disease: a review and study protocol on the effect of periodontal treatment on non-alcoholic fatty liver disease

文献摘要

相似文献