Title: 1218 - Relationships Between Nonalcoholic Fatty Liver Disease (NAFLD) and Oral Health


Jane Weintraub (Presenter)
University of North Carolina

Gabriela Lopez Mitnik, NIH
Bruce Dye, NIH


Objectives: Recent US estimates for nonalcoholic fatty liver disease (NAFLD) in US is 22% (51.6 million adults) with prevalence increasing. NAFLD shares some risk factors with periodontitis and dental caries. Our aim is to explore the association between oral diseases and tooth loss with NAFLD among US adults controlling for potential confounders and mediators.

Methods: The National Health and Nutrition Examination Survey, 1988-1994 (NHANES III) used ultrasound to assess liver fat accumulation, and dental examinations to assess periodontal disease, dental caries and tooth loss. Data from 10,541 dentate adults ≥20 years, who had an ultrasound and dental examination were used. Using previously reported definition, persons with moderate or severe hepatic steatosis in the absence of elevated alcohol consumption were considered to have NAFLD. Multivariable models were developed to examine the independent effects of moderate-severe periodontitis, untreated dental caries, and tooth loss on NAFLD while controlling for clinical, biological, and sociodemographic factors. Weighted estimates for Odds Ratios (ORs) and 95% Confidence Intervals (CI) were calculated using logistic regression.

Results: About 17% of adults had NAFLD. In unadjusted models, adults with NAFLD were more likely to have <20 teeth (OR=1.75; 95% CI:1.45-2.11); periodontitis (OR=1.76; 95%CI:1.37-2.27), and untreated dental caries (OR=1.34; 95%CI:1.11-1.62). After controlling for key confounders and mediators, these dental variables were no longer significant in parsimonious models. The covariates with highest magnitude of significance were elevated ALT blood levels (OR=3.07; 95%CI:2.39-3.95) and abnormal waist circumference (OR=3.38; 95%CI:2.79-4.11). Sex, race/ethnicity, hypertension, elevated AST and triglycerides were also independently associated with NAFLD.

Conclusions: NAFLD (assessed by ultrasound) was not associated with dental caries, periodontitis, and tooth loss after controlling for a number of key clinical, biological, and sociodemographic factors in the US. Given NAFLD prevalence is increasing, future studies incorporating temporality and recent data are needed to understand how shared risk factors affect NAFLD and oral health.

This abstract is based on research that was funded entirely or partially by an outside source:

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: None

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