Non-Cochrane · aetiology · PM41935147
Association between periodontitis and non-alcoholic fatty liver disease in community-dwelling adults: a systematic review and meta-analysis.
Li Hanyi, Shi Mingxuan, Yuan Ruomeng, et al. · Scientific reports · 2026 · PubMed · doi:10.1038/s41598-026-42308-2
Findings
Population Adults without known hepatic comorbidities (community-dwelling)
10 findings
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · Periodontitis diagnosis: probing depth (PPD) | OR 1.36 [0.79, 2.32] GRADE not reported 2 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · NAFLD diagnosis: other markers (ALT/AST, FLI, HSI) | OR 1.18 [0.95, 1.46] GRADE not reported 4 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies | OR 1.34 [1.13, 1.58] GRADE not reported 8 studies · 225091 participants |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · NAFLD diagnosis: ultrasonic testing | OR 1.67 [1.23, 2.23] GRADE not reported 2 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · Sensitivity: excluding the two probing depth studies | OR 1.38 [1.19, 1.6] GRADE not reported 6 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · Proportion of men < 50% | OR 1.3 [1.0, 1.68] GRADE not reported 4 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · Proportion of men > 50% | OR 1.51 [1.27, 1.79] GRADE not reported 3 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (incident) Follow-up (cohort) · Community-dwelling population studies | RR 1.22 [0.81, 1.84] GRADE not reported 2 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · NAFLD diagnosis: ICD-9-CM | OR 1.46 [1.21, 1.75] GRADE not reported 2 studies |
| Periodontitis | No periodontitis (periodontally healthy) | NAFLD (prevalence) Cross-sectional · Community-dwelling population studies · Periodontitis diagnosis: clinical attachment loss (CAL) | OR 1.38 [1.19, 1.6] GRADE not reported 6 studies |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Akinkugbe 2017 Periodontitis and Non-alcoholic Fatty Liver Disease, a population-based cohort investigation in the Study of Health in Pomerania. PMID:28804947 | 2017 | this review only | NAFLD (incident); PM41935147-P2-O1 | not extracted yet |
| Akinkugbe 2018 Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos. PMID:29717494 | 2018 | this review only | NAFLD (prevalence) | not extracted yet |
| Alazawi 2017 Periodontitis is associated with significant hepatic fibrosis in patients with non-alcoholic fatty liver disease. PMID:29220367 | 2017 | this review only | NAFLD (prevalence) | not extracted yet |
| Iwasaki 2018 Correlation between ultrasound-diagnosed non-alcoholic fatty liver and periodontal condition in a cross-sectional study in Japan. PMID:29760403 | 2018 | this review only | NAFLD (prevalence) | not extracted yet |
| Joo 2024 Association between nonalcoholic fatty liver disease scores and chronic periodontitis: A retrospective cohort study. PMID:38971999 | 2025 | this review only | not stated | not extracted yet |
| Kim 2020 Association between Fatty Liver Index and Periodontitis: the Korea National Health and Nutrition Examination Survey. PMID:32123238 | 2020 | this review only | NAFLD (prevalence) | not extracted yet |
| Ram 2022 The Triangle of Nonalcoholic Fatty Liver Disease, Metabolic Dysfunction, and Periodontitis: Analysis of the Dental, Oral, Medical and… PMID:36557250 | 2022 | this review only | NAFLD (prevalence) | not extracted yet |
| Shin 2020 Association between periodontal status and non-alcoholic fatty liver disease in a Korean adult population: A nationwide cross-sectional… PMID:31484207 | 2020 | this review only | NAFLD (prevalence) | not extracted yet |
| Shin 2022 matched by author and year (probable) | NR | this review only | NAFLD (incident); PM41935147-P2-O1 | not extracted yet |
| Weintraub 2019 Oral Diseases Associated with Nonalcoholic Fatty Liver Disease in the United States. PMID:31369716 | 2019 | this review only | NAFLD (prevalence) | not extracted yet |
| Wilensky 2023 Periodontitis and Metabolic Syndrome: Statistical and Machine Learning Analytics of a Nationwide Study. PMID:38135975 | 2023 | this review only | NAFLD (prevalence) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Community-dwelling adults aged 18 years or older without known hepatic comorbidities | Adults from USA, South Korea, Japan and Israel, aged 18 to 74 years (n=225,091 in 8 cross-sectional studies) |
| Intervention | Exposure: clinically verified periodontitis | Periodontitis defined by CAL (6 studies), PPD (2 studies) or CPI/AAP criteria |
| Comparison | Matched periodontally healthy subjects | Participants without periodontitis |
| Outcomes | Objectively confirmed NAFLD; risk estimates (OR, RR, HR); secondary: clinical attachment loss, probing depth | NAFLD (ultrasound, ICD-9-CM, FLI, ALT/AST) as odds ratio (8 cross-sectional studies); incident NAFLD as risk ratio (3 cohort studies) |
| Study designs | Observational (cross-sectional, case-control, cohort) or interventional studies with adequate sample sizes | 8 cross-sectional studies and 3 cohort studies |
| Timing | Not specified | Not specified |