Abstract:

Metabolic-associated fatty liver disease （MAFLD） is a common liver disorder， and its incidence continues to rise along with the increasing prevalence of metabolic diseases such as obesity and diabetes. chronic periodontitis（CP）， a prevalent oral disease， has also been confirmed to be closely associated with overall health. A certain correlation exists between CP and MAFLD. CP may affect hepatic fat metabolism through multiple pathways， thereby increasing the risk of MAFLD. Periodontal pathogens and their metabolites may directly act on the liver， inhibiting the insulin signaling pathway， reducing hepatic glycogen synthesis， and leading to hyperglycemia. The chronic inflammatory response induced by CP elevates the levels of pro-inflammatory cytokines in the blood， such as tumor necrosis factor α（TNF-α） and interleukin-6 （IL-6）. These factors can disrupt the adipocytes and affect the balance of adipokines， thus leading to hepatic insulin resistance. CP also increases the level of reactive oxygen species （ROS） in the blood， triggering systemic oxidative stress， damaging liver cells， and exacerbating the condition of MAFLD. Furthermore， CP may influence hepatic fat metabolism and inflammatory response by activating signaling pathways such as nuclear factor κB （NF-κB）， c-Jun N-terminal kinase （JNK）， and high mobility group box 1-Toll-like receptors （HMGB1-TLR）， thereby promoting the occurrence and development of MAFLD. Future studies are needed to explore the association mechanism between CP and MAFLD， and to conduct cohort studies and prospective studies to evaluate the impact of CP treatment on the patients with MAFLD. Additionally， combined treatment strategies， such as dietary adjustments， exercise， and anti-inflammatory drug therapy， should be explored to improve therapeutic outcomes. This review summarized the correlation between CP and MAFLD， providing new insights for clinical practice， and reminding clinicians to pay attention to the periodontal health status of patients and take appropriate preventive and therapeutic measures when treating MAFLD.

Key words: Chronic periodontitis, Metabolic fatty liver disease, Epidemiology, Inflammatory response, Oxidative stress