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<p>Both non-alcoholic fatty liver disease (NAFLD) and periodontitis are prevalent chronic conditions. While prior research indicates a possible connection between these diseases, the conclusions in the existing literature are highly variable and the findings are inconsistent. Consequently, there is an urgent need for a comprehensive evaluation of this relationship. This study conducted a systematic search of the PubMed, Embase, Scopus, and Web of Science databases, encompassing research published up to June 25, 2025, to assess the association between NAFLD and periodontitis. The review incorporated cross-sectional, case-control, and cohort studies. A meta-analysis was performed utilizing a random effects model, with subgroup and sensitivity analyses conducted to investigate potential sources of heterogeneity. From 628 initially identified records, 11 studies (8 cross-sectional, 3 cohort) involving a total of 225,091 participants were included. The meta-analysis of cross-sectional studies demonstrated a significant positive association between periodontitis and NAFLD (OR:1.34, 95% CI:1.13,1.58), albeit with substantial heterogeneity (<i>I²</i> =68%). Subgroup analysis revealed that studies using clinical attachment loss (CAL) for periodontitis diagnosis showed a stronger and more robust association (OR: 1.38, 95% CI: 1.19, 1.60) with low heterogeneity (<i>I²</i> = 25%), unlike those using probing depth. The limited cohort studies suggested a potential bidirectional relationship, but heterogeneity precluded quantitative synthesis, highlighting the need for more high-quality prospective studies. Current evidence confirms a significant association between periodontitis and NAFLD, which is strongest and most consistent when periodontitis is defined by CAL, a marker of cumulative tissue destruction. These findings underscore the importance of standardized, tissue-based periodontitis diagnosis in future research and suggest potential implications for interdisciplinary patient management between dental and hepatology practices.</p>

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Association between periodontitis and non-alcoholic fatty liver disease in community-dwelling adults: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月4日

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  • Hanyi Li,
  • Mingxuan Shi,
  • Ruomeng Yuan,
  • Huihui Wang,
  • Yi Li

摘要

Both non-alcoholic fatty liver disease (NAFLD) and periodontitis are prevalent chronic conditions. While prior research indicates a possible connection between these diseases, the conclusions in the existing literature are highly variable and the findings are inconsistent. Consequently, there is an urgent need for a comprehensive evaluation of this relationship. This study conducted a systematic search of the PubMed, Embase, Scopus, and Web of Science databases, encompassing research published up to June 25, 2025, to assess the association between NAFLD and periodontitis. The review incorporated cross-sectional, case-control, and cohort studies. A meta-analysis was performed utilizing a random effects model, with subgroup and sensitivity analyses conducted to investigate potential sources of heterogeneity. From 628 initially identified records, 11 studies (8 cross-sectional, 3 cohort) involving a total of 225,091 participants were included. The meta-analysis of cross-sectional studies demonstrated a significant positive association between periodontitis and NAFLD (OR:1.34, 95% CI:1.13,1.58), albeit with substantial heterogeneity (I² =68%). Subgroup analysis revealed that studies using clinical attachment loss (CAL) for periodontitis diagnosis showed a stronger and more robust association (OR: 1.38, 95% CI: 1.19, 1.60) with low heterogeneity (I² = 25%), unlike those using probing depth. The limited cohort studies suggested a potential bidirectional relationship, but heterogeneity precluded quantitative synthesis, highlighting the need for more high-quality prospective studies. Current evidence confirms a significant association between periodontitis and NAFLD, which is strongest and most consistent when periodontitis is defined by CAL, a marker of cumulative tissue destruction. These findings underscore the importance of standardized, tissue-based periodontitis diagnosis in future research and suggest potential implications for interdisciplinary patient management between dental and hepatology practices.