Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes.

Hasaan G Mohamed,Shaza B Idris,Kamal Mustafa,Manal Mustafa,Mutaz F Ahmed,Salah O Ibrahim,Anne N Åstrøm,Sompop Bencharit

doi:10.1371/journal.pone.0127660

Hasaan G Mohamed, Shaza B Idris + Show 6 more

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https://doi.org/10.1371/journal.pone.0127660

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Abstract

The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF) is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM) presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1), 24 with T2DM (G2), 30 with chronic periodontitis (G3) and 44 without T2DM or periodontitis (G4). The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman’s correlation co-efficient: -0.240, P < 0.01) and positively with GIP and visfatin (Spearman’s correlation co-efficient: 0.255 and 0.241, respectively, P < 0.01). The results demonstrate that chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.

Highlights

Diabetes mellitus represents a heterogeneous group of metabolic disorders associated with disturbances of carbohydrate, fat and protein metabolism
Type 2 diabetes (T2DM) is characterized by elevated blood glucose levels caused by increased production of glucose in the liver and increased peripheral insulin resistance, which might eventually lead to a reduction in insulin secretion [1]
The aim of the study was to investigate the influence of chronic periodontitis on the levels of glucoregulatory biomarkers in the gingival crevicular fluid (GCF), by comparing the levels of the above biomarkers in subjects with T2DM, with and without chronic periodontitis, and in subjects without diabetes, with and without chronic periodontitis

Summary

Introduction

Diabetes mellitus represents a heterogeneous group of metabolic disorders associated with disturbances of carbohydrate, fat and protein metabolism. Type 2 diabetes (T2DM) is characterized by elevated blood glucose levels caused by increased production of glucose in the liver and increased peripheral insulin resistance, which might eventually lead to a reduction in insulin secretion [1]. In sub-Saharan Africa, T2DM is becoming increasingly prevalent, presenting a major public health burden in countries with scarce resources [2]. Of particular concern is the fact that the onset is insidious and the condition may remain undiagnosed for a long time. In this context, the dental profession has a potentially important role and the condition may first be identified during a dental examination [4]

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