MODERN PERCEPTIONS ON THE ETIOLOGY AND PATHOGENESIS OF PARODONTITIS IN PATIENTS WITH METABOLICALLY ASSOCIATED FAT DISEASES OF THE LIVER

Аннотация

The article examines modern understanding of the relationship between periodontitis and metabolically associated fatty liver disease (MASLD). An analysis of literature data confirming the presence of general pathogenetic mechanisms, including systemic inflammation, oxidative stress, microbiota dysbiosis, and insulin resistance, was conducted. Periodontal pathogens, by penetrating the systemic bloodstream, contribute to the activation of liver Toll-like receptors and the enhancement of the inflammatory response, which plays a role in the development of steatosis and liver fibrosis. In turn, metabolic disorders in MASLD exacerbate the course of periodontitis due to a decrease in antioxidant defense and changes in vascular reactivity. Key metabolic pathways linking both diseases, including TLR4/NF-κB activation, insulin signaling disorder (PI3K/Akt), and PPAR-γ dysregulation, have been identified. Potential prognostic criteria are presented - levels of CRP, IL-6, TNF-α, HOMA-IR indicators and liver enzyme activity, as well as clinical periodontal indices. The need for a multidisciplinary approach and early prevention aimed at correcting inflammatory and metabolic disorders is noted.