Comorbidity of periodontal diseases and non-alcoholic fatty liver disease

Abstract

Among dental pathologies, periodontal diseases occupy the 2nd place in prevalence after caries. The prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population in the world reaches 33.0% and is detected in all age categories. The presence of common risk factors suggests an indirect interaction between periodontitis and NAFLD, but the question of the possibility of direct interaction without the participation of “intermediaries” is relevant. The review examines the bidirectional relationship between periodontal pathology and NAFLD. The results of experimental and clinical studies indicate that periodontal bacteria, especially Porphyromonas gingivalis, correlate with the development of NAFLD. P. gingivalis has been detected in the liver, and LPS from this bacterium has been shown to be involved in the progression of NAFLD, suggesting a possible direct role of P. gingivalis in NAFLD. In addition, P. gingivalis causes disruption of the intestinal microbiocenosis, which contributes to the progression of NAFLD. There are two possible routes connecting the oral cavity and the liver - hematogenous and enteral diffusion of hepatotoxic components. The emerging concept of changes in the oral microbiota associated with periodontitis is closely related to the role of the mouth-gut-liver axis in the pathogenesis of NAFLD, based on the close relationship between the gut and liver connected by the enterohepatic circulation.