The study found that patients with metabolic dysfunction-associated fatty liver (MASLD) with moderate to severe periodontitis had a 29% higher risk of all-cause death and a 41% higher risk of cardiovascular-associated death compared with patients without gum disease or mild gum disease. It is worth noting that cancer-related mortality rates have not been affected.
The findings, published in the journal BMC Oral Health, suggest that incorporating routine oral health assessments into MASLD management can play an important role in improving long-term survival outcomes.
Previous studies have identified periodontitis as a potential risk factor for MASLD. MASLD is a common liver disease that is associated with metabolic disorders such as obesity and insulin resistance. Given the common inflammatory pathways between these two diseases, there is increasing concern about how poor oral health affects the progression and prognosis of patients with MASLD.
Against this background, Chen Guanhui, Department of Dental, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, and his colleagues aim to study the relationship between periodontitis and mortality in patients with MASLD, with particular attention to all-cause mortality and mortality in specific causes.
To this end, researchers included 11,019 patients with metabolic dysfunction-related steatosis liver disease from the National Health and Nutrition Examination Survey (NHANES). They used a multivariate Cox proportional hazard model to assess the hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality and cause-specific mortality based on the severity of periodontitis.
To further examine the dose-response relationship, restricted cubic spline (RCS) curves were used for analysis based on clinical attachment level (CAL) and periodontal pocket exploration depth (PPD). At the same time, to ensure the reliability and robustness of the research results, a series of sensitivity and stratified analyses were conducted.
The main findings of this study are as follows:
Moderate to severe periodontitis was associated with a 29% higher risk of all-cause mortality in MASLD participants (HR 1.29).
Among MASLD individuals with moderate to severe periodontitis, the risk of cardiovascular disease-related death was increased by 41% (HR 1.41).
Among MASLD participants, no significant association was found between periodontal condition and cancer-related mortality.
In this nationally representative large study, the authors found that moderate to severe periodontitis was associated with significant increase in all-cause mortality and cardiovascular-related mortality in patients with metabolic dysfunction-associated fatty liver. Higher clinical attachment loss levels and periodontal pocket exploration depth are also associated with increased risk, highlighting the prognostic value of periodontitis in MASLD.
As the first of its kind, the authors stress the need for further research to confirm these findings and explore causality. They also pointed to limitations of this study, including baseline data collection and differences in the classification method of periodontitis compared to other studies.
Related topics:
