Effect of non-surgical periodontal treatment on crevicular levels of Chemerin and Fibroblast growth factor 21 in controlled type 2 diabetic and non-diabetic patients both with periodontitis and their glycemic control. A clinical trial

Abstract

Background: Diabetes mellitus is one of the important host risk factors in periodontal diseases. Many factors were reported not only to play a role in the periodontal inflammation, but also to be associated with the severity of the tissue breakdown such as chemerins which are believed to be involved in a variety of chronic inflammatory conditions including diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is connected with regulation of glucose metabolism and was shown to be increased in patients with obesity and type 2 diabetes mellitus (T2DM). The present study aimed to explore the effect of non –surgical periodontal treatment on the gingival crevicular fluid level of Chemerin and FGF21in both controlled diabetic and non-diabetic patients both suffering from periodontitis and to detect the effects of this treatment on the glycemic control of diabetic patients.Methods: The study was conducted on 2 groups; group (A) included fifteen controlled T2 DM patients suffering from periodontitis, and group (B) included fifteen patients suffering from periodontitis.At baseline, GCF samples were collected from all participants for assessment of Chemerin and FGF 21 levels and 3 months after scaling and root planing (SRP). Samples were analysed using ELISA technique. Blood samples were also collected for assessment of HA1c. Results: Significantly higher levels of Chemerin and FGF21 were found in periodontitis patients with diabetes than in the periodontitis patients without diabetes. After periodontal therapy, there was a significant reduction in the GCF levels of chemerin and FGF21 in both periodontitis groups. All clinical parameters showed a significant improvement after treatment. HbA1c did not correlate significantly with any of the studied adipokines as well as any of the clinical parameters in the diabetic group.Conclusion: Periodontitis and T2DM share the nature of inflammation, with adipokines such as Chemerin and FGF21 involved in the process of inflammation. Chemerin exerts a proinflammatory influence on periodontitis and t2DM, also, FGF21 is a potent metabolic regulator with multiple beneficial effects on periodontitis and diabetes.