New Study Shows Association Between Periodontitis and Abnormal Liver Test Results

"Among more than 10,000 participants, periodontitis was associated with elevated levels of total protein, globulin, gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP). Notably, individuals aged 45-64 demonstrated higher odds of elevated ALT levels (adjusted odds ratio [aOR] 1.73), while those aged 65 and older showed a stronger association with elevated ALP levels (aOR 5.39)," the researchers reported in Journal of Dental Sciences.

Periodontitis, a chronic inflammatory disease, is a major global health issue, with 69% of Chinese adults aged 55–64 affected. Its association with systemic conditions like diabetes and cardiovascular diseases is growing. While previous research has suggested a link between periodontitis and various liver diseases, large-scale population studies have been limited. Therefore, Jianxia Hou, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China, and colleagues aimed to thoroughly explore the connections between periodontitis and liver function test markers.

For this purpose, the researchers utilized data from the NHANES databases from 2009 to 2014, including a study population of 10,139 participants. The liver function tests (LFTs) assessed included total protein (TP), albumin (ALB), globulin (GLB), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (γ-GGT), and alkaline phosphatase (ALP). Propensity score matching (PSM) was applied to enhance comparison, and multiple logistic regressions were used to investigate the associations between periodontitis and LFT abnormalities in the overall sample and across age subgroups.

The analysis uncovered the following findings:

• After adjusting for propensity score matching (PSM), logistic regression results showed that periodontitis was significantly associated with an increased risk of total protein (TP) (adjusted odds ratio [AOR] 1.46).
• Periodontitis was also linked to elevated globulin (GLB) levels (AOR 2.02).
• The condition was associated with higher γ-glutamyl transferase levels (AOR 1.32).
• Periodontitis was significantly related to increased alkaline phosphatase levels (AOR 2.00).
• In the subgroup of individuals aged 45–64, periodontitis showed elevated odds of higher alanine transaminase levels (AOR 1.73).
• In those aged 65 years or older, there was a statistically significant association between periodontitis and higher ALP levels (AOR 5.39).

The study found a significant association between periodontitis and certain liver function abnormalities. The researchers noted that periodontitis was linked to an increased risk of elevated γ-GGT, ALP, and GLB levels, indicative of cholestatic liver diseases and heightened immune activity. Furthermore, the impact of periodontitis on liver function appeared to vary across different age groups.

"These findings warrant further confirmation through additional observational studies and animal experiments to better understand the underlying mechanisms and the clinical implications of this association," the researchers concluded.

Reference:

Zhang, J., Xing, X., Han, Y., Meng, H., Hou, J., & Zhu, H. (2025). Potential association between periodontitis and liver function test abnormalities: Results from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. Journal of Dental Sciences. https://doi.org/10.1016/j.jds.2025.01.005