Is Periodontal Inflammation Associated with Liver Cirrhosis? A Cross-Sectional Study.

Abstract

Background: Periodontitis is linked to a range of systemic non-communicable diseases, including hepatic diseases. The aim of this study was to investigate whether periodontal health status is associated with liver cirrhosis (LC). Methods: Patients were recruited from the Department of Internal Medicine at the University Clinical Hospital "Sestre Milosrdnice" and categorized into two groups. The case group comprised patients with LC, while age-matched individuals without LC served as controls. Systemic health status was evaluated through laboratory tests, medical history, and clinical parameters, and the Model for End-Stage Liver Disease (MELD) score was calculated for each participant. A comprehensive clinical periodontal assessment was conducted, measuring bleeding on probing (BoP), probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and the Periodontal Inflamed Surface Area (PISA) score. Stepwise logistic regression was employed to assess possible predictors of LC, including periodontal status. Results: A total of 100 patients were included in the analysis, consisting of 50 cases with LC and 50 controls. The mean age was 56.79 years (SD = 11.16) of participants, and 58% were male. The majority of LC cases were attributed to alcohol abuse (41/50, 82%), and the median MELD score was 16 (IQR 6-33). Comparison of the two groups revealed significantly worse clinical periodontal parameters in the LC group and a higher prevalence of periodontitis (p = 0.012). Among the 50 LC patients, 46 (92%) exhibited severe forms of periodontitis (stages III and IV). Logistic regression analysis identified alcohol consumption and the PISA score as independent predictors of LC (OR = 23.81, 95% CI 4.48-126.47, p < 0.001; OR = 1.006, 95% CI 1.003-1.01, p < 0.001, respectively). Conclusions: Within the limits of the present study, the higher prevalence of periodontal disease in the LC group suggests an association between LC and periodontitis.