Helenius-Hietala, J., Suominen, A. L., Ruokonen, H., Knuuttila, M., Puukka, P., Jula, A., … Åberg, F. (2018). Periodontitis is associated with incident chronic liver disease-A population-based cohort study. Liver International, 39(3), 583–591. https://doi.org/10.1111/liv.13985
Periodontitis is associated with incident chronic liver disease : a population-based cohort study
|Author:||Helenius‐Hietala, Jaana1; Suominen, Anna Liisa2,3,4; Ruokonen, Hellevi1;|
1Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
3Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
4Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
5Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
6Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
7Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
8The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
|Online Access:||PDF Full Text (PDF, 0.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019090426708
John Wiley & Sons,
|Publish Date:|| 2019-10-09
Background & Aims: Chronic liver disease is a major health concern worldwide and the identification of novel modifiable risk factors may benefit subjects at risk. Few studies have analyzed periodontitis as a risk factor for liver complications. We studied whether periodontitis is associated with incident severe liver disease.
Methods: The study comprised 6165 individuals without baseline liver disease who participated in the Finnish population‐based Health 2000 Survey (BRIF8901) during 2000‐2001, a nationally representative cohort. Follow‐up was until 2013 for liver‐related admissions, liver cancer and mortality from National Hospital Discharge, Finnish Cancer Registry and Causes of Death Register, Statistics Finland. Mild to moderate periodontitis was defined as ≥1 tooth with periodontal pocket ≥4 mm deep, and advanced periodontitis as ≥5 teeth with such pockets. Multiple confounders were considered.
Results: A total of 79 subjects experienced a severe liver event during follow‐up. When adjusted for age, sex and number of teeth, hazards ratios by Cox regression regarding incident severe liver disease were, for mild to moderate periodontitis, 2.12 (95% CI 0.98‐4.58), and, for advanced periodontitis, 3.69 (95% CI 1.79‐7.60). These risk estimates remained stable after additionally adjusting for alcohol use, smoking, metabolic risk, serum gamma‐glutamyltransferase, dental‐care habits, lifestyle and socioeconomic status. Periodontal disease‐associated liver risk was accentuated among subjects with non‐alcoholic fatty liver disease or heavy alcohol use at baseline.
Conclusions: Periodontitis was associated with incident liver disease in the general population independently of various confounders. As a preventable disease, periodontal disease might present a modifiable risk factor for chronic liver disease.
|Pages:||583 - 591|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3142 Public health care science, environmental and occupational health
JHH received research grants from the Ehrnrooth Foundation and from Helsinki UniversityHospital EVO grant. FÅ received research grants from the Ehrnrooth Foundation and from Finska Läkaresällskapet.
© 2018 John Wiley & Sons A/S. This is the peer reviewed version of the following article: Helenius-Hietala, J., Suominen, A. L., Ruokonen, H., Knuuttila, M., Puukka, P., Jula, A., … Åberg, F. (2018). Periodontitis is associated with incident chronic liver disease-A population-based cohort study. Liver International, 39(3), 583–591. https://doi.org/10.1111/liv.13985, which has been published in final form at https://doi.org/10.1111/liv.13985. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.