An Assessment of Salivary Leptin and Resistin Levels in Type Two Diabetic Patients with Chronic Periodontitis : A Comparative Study

Abstract

Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been focus of many researches. Currently there is an appreciation to role of adipose tissue-derived substances the in immune-inflammatory responses; also, there is an interest in using simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine periodontal health status in chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure salivary levels of two adipokines and resistin, pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in each study and control groups. Materials and Methods: Seventy five males were recruited for study, with an age range of (35-50) years. The subjects were divided into four groups: two non-diabetic groups: one of them with healthy periodontium and systemically healthy (Control, 15 subjects) and other with chronic periodontitis (20 patients) and two type 2 diabetic groups: well controlled (20 patients) and poorly controlled (20 patients) both of them with chronic periodontitis.Unstimulated whole salivary samples were collected from all of participants; salivary flow rate and pH were measured and then biochemically analyzed for assessment of resistin and leptin levels.Clinical periodontal parameters included: plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level had been recorded for all subjects at four sites per tooth except for third molars. Results: The results of clinical periodontal examination revealed that group of chronic periodontitis with poorly controlled type 2 diabetes mellitus had worst periodontal health status. The biochemical analysis demonstrated that lowest level of salivary leptin was foundin chronic periodontitis with poorly controlled type 2 diabetes mellitus group. In addition, highest level of salivary resistin was demonstrated in chronic periodontitis with well controlled type 2 diabetes mellitus group. When salivary flow rate and pH were measured, it was found that they were decreased in study groups as compared to control group. A non-significant moderate negative correlation between salivary leptin with pH in control group was found. While, salivary resistin demonstrated a high significant moderate positive correlation with gingival index in non-diabeticchronic periodontitis group and a non-significant moderate negative correlation with salivary flow ratein control group. Finally, study found that correlation between salivary leptin and resistin was non-significant weak negative in each of study and control groups. Conclusion: It can be concluded that poorly controlled type 2 diabetic patients have more periodontal tissue destruction and less salivary flow rate than well controlled type 2 diabetic patients and non-diabetic patients all of them with chronic periodontitis. Salivary Resistin and Leptin hormones may be useful biochemical markers of periodontal tissue destruction and this will provide better opportunities in early diagnosis, monitoring and efficient management of periodontal diseases and T2DM.