Association Between Oral Health and Metabolic Dysfunction–Associated Steatotic Liver Disease Among US Adults
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease, yet extrametabolic contributors such as oral health remain underexplored. While periodontitis has been linked to nonalcoholic fatty liver disease, untreated caries and unmet dental care needs have been less examined under new MASLD criteria. We evaluated associations between examiner-assessed oral health indicators and MASLD in a nationally representative sample of US adults. METHODS: We analyzed 2,528 adults aged 18 years or older from the 2017-2020 National Health and Nutrition Examination Survey with valid liver transient elastography. MASLD was defined as steatosis (controlled attenuation parameter ≥285 dB/m) plus ≥1 metabolic risk factor. Examined oral health indicators included examiner-assessed need for dental care, decayed teeth, gum disease, and a composite of decayed teeth or gum disease. Survey-weighted logistic regression estimated odds ratios (ORs) adjusted for sociodemographic and behavioral factors. RESULTS: MASLD prevalence was 38.9%. In fully adjusted models, needing dental care (OR = 1.42, 95% CI: 1.02-1.95) and having decayed teeth (OR = 1.52, 95% CI: 1.05-2.20) were associated with higher MASLD odds. After false discovery rate correction, only dental care need remained significant (q = 0.043). Sex-stratified analyses revealed pronounced associations in women, who had 91% higher MASLD odds if dental care was needed (OR = 1.91, 95% CI: 1.18-3.10) and 156% higher odds with decayed teeth (OR = 2.56, 95% CI: 1.35-4.84). Significant associations were also observed in adults aged 45-59 and 60 years or older. DISCUSSION: Unmet dental needs and caries are associated with MASLD, with particularly strong associations observed in women. These findings highlight oral health as a potential marker for MASLD risk and underscore the value of integrated oral-systemic assessments in preventive care.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
Funders: Jülich Supercomputing Centre, Forschungszentrum Jülich, Welch Foundation, Camille and Henry Dreyfus Foundation, UNICEF, Arkansas Biosciences Institute, Louisiana Transportation Research Center, Japan Agency for Medical Research and Development, Cooperative Research Centre for Developing Northern Australia, UK Research and Innovation, Ministerio de Ciencia, Innovación y Universidades, Göran Gustafssons Stiftelser, Purdue Institute for Drug Discovery, Kyorin Pharmaceutical, Horizon Therapeutics, Royal Society, European Commission, Royal Australasian College of Physicians, Deutsche Forschungsgemeinschaft, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Danmarks Grundforskningsfond, Deakin University, Fundação de Amparo à Pesquisa do Estado de São Paulo, National Natural Science Foundation of China, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Bundesministerium für Bildung und Forschung, Hunan Provincial Science and Technology Department, Cancerfonden, Natural Science Foundation of Fujian Province, Conselho Nacional de Desenvolvimento Científico e Tecnológico, National Research Foundation of Korea, Narodowe Centrum Nauki, Vetenskapsrådet, Natural Science Foundation of Gansu Province, University of Electronic Science and Technology of China, Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul, Natural Science Foundation of Shandong Province, Région Auvergne-Rhône-Alpes, Université de Lyon, Taipei Veterans General Hospital, Townsville Hospital and Health Service, École Normale Supérieure de Lyon, Gauss Centre for Supercomputing, Commercializations Promotion Agency for R and D Outcomes, National Institutes of Health, National Institute of Food and Agriculture, U.S. Bureau of Land Management, Agricultural Research Service, Sichuan Province Science and Technology Support Program, Multidisciplinary University Research Initiative, Metro North Hospital and Health Service, HORIZON EUROPE Framework Programme, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Australian Research Council, Japan Society for the Promotion of Science, Instituto de Salud Carlos III, Agencia Estatal de Investigación, National Key Research and Development Program of China, Fundamental Research Funds for the Central Universities, Basic and Applied Basic Research Foundation of Guangdong Province, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, National Institute of Environmental Health Sciences, Division of Environmental Biology, Basic Energy Sciences, Technology Development, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Digital Health CRC
OpenAlex ID: W7126159297