An exploratory study of periodontal therapy to improve non-alcoholic fatty liver disease

doi:10.16138/j.1673-6087.2024.03.03

Abstract

Abstract:

Objective To study the effect of Porphyromonas gingivalis (P.g) on non-alcoholic fatty liver disease (NAFLD) and the ameliorative effect of periodontal treatment on NAFLD. Methods Mice fed a high-fat diet for 4 weeks were randomly divided into two groups, and there were 8 mice in each group. Group A was blank control, and Group B was given suture ligation + smeared P.g. They were sacrificed after 4 weeks of intervention, and the changes in liver, inflammatory factors were tested. Eight NAFLD patients with periodontal disease were randomly divided into the subgingival scaling group and the control group (4 in each group), and the subgingival scaling group received the basic periodontal treatment. Changes in periodontal status, liver, and blood biochemistry before and after the intervention were tested in the 2 group patients. Results Compared with the control mouse group, the ligation and smear mouse group had increased liver weight, formation of lipid deposits, serum lipid, aspartate transaminase and ferritin levels, and the expression of serum inflammatory mediators was increased. Compared with the patients in the tooth brushing group, the subgingival scraping patient group showed a significantly decreased indexes such as P.g-IgG antibody titer, probing depth, as well as a downward trend in liver fat content, but the differences were not statistically significant （P>0.05）. Conclusions P.g infection can accelerate the progression of NAFLD in mice with high-fat diet, and the periodontal treatment in patients showed a mitigating effect on periodontal infection-associated NAFLD.

Key words: Subgingival scaling, Periodontal disease, Non-alcoholic fatty liver disease, Porphyromonas gingivalis

CLC Number:

R575.5

DUAN Zhonghua, MA Xueying, WU Yuqiong, SHU Jiaen, WU Pei, GUO Simin, WANG Yuhua. An exploratory study of periodontal therapy to improve non-alcoholic fatty liver disease[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(03): 167-173.

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References 23

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时间(d)	对照组	结扎+涂抹P.g菌组	t	P
0	22.52±0.47	22.39±0.50	0.561	0.583
4	24.34±0.64	23.82±0.59	1.667	0.118
7	25.18±0.66	25.01±0.67	0.520	0.611
11	26.15±0.88	25.56±0.73	1.462	0.166
14	26.79±1.23	26.27±0.76	1.023	0.324
18	27.36±1.32	27.21±0.84	0.271	0.790
21	28.42±1.43	28.19±1.03	0.363	0.722
24	28.92±1.67	28.86±0.96	0.092	0.928
28	30.13±1.90	29.86±1.19	0.350	0.731
32	30.43±1.00	27.74±1.89	3.138	0.009
36	30.71±1.72	27.45±2.92	2.425	0.032
40	32.05±2.12	27.66±2.72	3.268	0.007
44	32.58±1.95	29.06±2.62	2.756	0.017
48	33.72±1.95	28.83±4.15	2.651	0.021
52	33.98±1.98	35.75±2.05	2.364	0.038
56	35.75±2.05	29.40±4.70	2.804	0.019

项目	对照组	结扎+涂抹P.g菌组	t	P
TG(mmol/L)	1.16±0.07	2.07±0.33	4.479	0.009
总胆固醇(mmol/L)	4.46±1.04	4.48±0.85	0.032	0.975
AST(mmol/L)	210.11±88.62	475.52±159.19	2.962	0.021
ALT(mmol/L)	69.07±36.93	133.42±98.07	1.063	0.329

项目	对照组	结扎+涂抹P.g菌组	t	P
TNF-α	340.17±47.95	504.62±61.19	4.593	<0.001
IL-1β	54.68±3.26	76.33±12.68	3.287	0.007
IL-6	57.54±10.44	82.40±2.88	5.674	<0.001
铁蛋白	13.21±3.79	18.82±3.83	2.727	0.010

项目	刷牙组					龈下刮治组
项目	0个月	3个月	6个月	ΔE_3-0	ΔE_6-0	0个月	3个月	6个月	ΔE_3-0	ΔE_6-0
P.g-lgG抗体滴度（ng/mL）	4.93±0.04	4.70±0.77	4.19±0.41	-0.23±0.81^1）	-0.74±0.4^1）	5.11±0.29^2）	3.57±0.56	3.47±0.93	-1.54±0.32^1）2）	-1.64±0.65^1）2）
PD（mm）	3.15±0.46	2.96±0.50	3.02±0.65	-0.19±0.34^1）	-0.14±0.24^1）	3.66±1.46^2）	3.19±1.20	3.13±1.19	-0.47±0.37^1）2）	-0.53±0.34^1）2）
CAL（mm）	3.61±0.58	3.39±0.31	3.54±0.42	-0.21±0.33^1）	-0.06±0.24^1）	3.82±1.91^2）	3.28±1.12	3.42±1.72	-0.54±1.00^1）2）	-0.39±0.33^1）2）
菌斑指数（分）	2.09±0.17	1.40±0.15	1.51±0.10	-0.69±0.20^1）	-0.58±0.18^1）	1.87±0.37^2）	1.35±0.31	1.43±0.21	-0.52±0.23^1）2）	-0.44±0.36^1）2）
探诊出血百分数（%）	49.75±4.71	43.90±5.23	44.50±4.43	-5.85±3.37^1）	-5.25±2.12^1）	59.28±11.22^2）	44.40±8.97	38.83±11.05	-14.88±18.23^1）2）	-20.45±18.37^1）2）
BMI（kg/m²）	27.65±5.09	27.90±5.06	27.65±5.07	0.25±0.64^1）	0.00±0.43^1）	26.85±1.26^2）	26.35±1.40	26.88±1.49	-0.50±0.93^1）2）	0.03±0.72^1）2）

项目	刷牙组					龈下刮治组
项目	0个月	3个月	6个月	ΔE_3-0	ΔE_6-0	0个月	3个月	6个月	ΔE_3-0	ΔE_6-0
肝脏脂肪含量CAP（db/m）	285.00±39.41	290.25±32.94	287.50±45.99	5.25±27.16^1）	2.50±65.37^1）	273.75±39.82^2）	248.50±24.69	264.50±45.57	-25.25±33.57^1）2）	-9.25±26.59^1）2）
AST（U/L）	30.75±6.24	28.25±8.66	31.00±4.69	-2.50±4.51^1）	0.25±3.20^1）	28.50±5.97^2）	20.25±1.71	23.00±3.46	-8.25±4.57^1）2）	-5.50±9.00^1）2）
ALT（U/L）	36.25±5.12	32.25±7.37	38.50±2.38	-4.00±8.83^1）	2.25±7.27^1）	37.75±11.62^2）	20.25±4.03	26.00±1.15	-17.50±9.47^1）2）	-11.75±12.42^1）2）
肝脏硬度TE（kPa）	5.43±1.15	5.30±0.81	6.78±1.96	-0.13±1.37^1）	1.35±2.26^1）	5.08±0.96^2）	5.63±2.25	5.00±0.36	0.55±2.47^1）2）	-0.08±0.88^1）2）
Ⅳ型胶原（ng/mL）	31.06±12.03	29.72±20.35	29.42±6.80	-1.35±21.63^1）	-1.64±6.40^1）	30.52±11.66^2）	26.21±7.51	23.27±9.53	-4.31±6.71^1）2）	-7.25±7.87^1）2）
总胆固醇（mmol/L）	4.98±0.39	5.47±0.73	5.50±1.17	0.48±0.45^1）	0.52±1.26^1）	5.32±1.15^2）	5.61±0.70	5.31±1.08	0.29±0.47^1）2）	-0.01±0.40^1）2）