Abstract
Periodontal disease is an infectious-inflammatory disease with widespread systemic effects. Accumulating evidence from clinical and experimental studies has elucidated the mechanisms by which periodontal disease influences systemic energy metabolism, including glucose and lipid metabolisms. These effects are thought to arise from the persistent immune activation associated with periodontitis, leading to systemic inflammatory responses. Specifically, chronic inflammation, such as periodontitis, promotes the infiltration of pro-inflammatory immune cells into adipose tissue, activates immune-metabolic signaling pathways involving dendritic cells, macrophages and T cells, and disrupts thermogenesis and lipid metabolism in adipose tissue and the liver. In addition, periodontal disease has been implicated in alterations in the gut microbiota through the oral-microbiota-gut axis, further contributing to metabolic dysregulation. Collectively, these findings suggest that the influence of periodontal disease on energy metabolism is multifaceted and complex and involves coordinated disturbances in immune regulation, adipose tissue function, hepatic metabolic processes, and gut microbiota homeostasis, ultimately resulting in impaired systemic energy metabolic regulation.