Porphyromonas gingivalis and non-alcoholic fatty liver disease as combined factors of periodontitis

Abstract

Purpose: This study is to determine the quantitative level of Porphyromonas gingivalis (P. gingivalis) in the periodontal pocket and its gingipain virulence factor in patients with non-alcoholic fatty liver disease (NAFLD). Methods: Dental status, composition of P. gingivalis, and levels of gingipain and blood endotoxin were studied in patients with NAFLD and in a control group. The quantitative composition of P. gingivalis was determined by the real-time quantitative polymerase chain reaction method (qRT-PCR). Gingipain K concentration in oral fluid was determined by an immunoenzymatic method. Results: The level of individual oral hygiene in the NAFLD patients was found to be unsatisfactory. Structurally, periodontal pathology was represented mainly by chronic grade B periodontitis. When analysing the correlation interaction, a positive dynamic was found between P. gingivalis and the presence of generalized periodontitis (GP) (r=0.652; p=0.000) and between gingipain and GP (r=0.510; p=0.006). The endotoxemia value correlated positively with the quantitative index of P. gingivalis (r=0.695; p=0.004), which is explained by the fact that periodontopathogen endotoxin (LPS), when entering the vascular bed, increases the systemic endotoxin level in general. Inflammation-causing cytokines and LPS in NAFLD contribute to the formation of an anaerobic environment in the periodontium that favours the quantitative growth of P. gingivalis. Conclusion: The highest levels of P. gingivalis and gingipain were recorded in patients with NAFLD, which is consistent with a background of decreased periodontal adaptive capabilities. The P. gingivalis/gingipain correlation ratio can allow the dentist to monitor the treatment of periodontal patients.