Impact of concurrent diabetes on periodontal health in patients with acromegaly

Mili Gupta,Shipra Gupta,Nandini Bhaskar,Anil Bhansali,Akanksha Jain,Ashish Jain,Rose Kanwaljeet Kaur

doi:10.1038/s41598-020-76067-5

Abstract

Previous studies have suggested excess GH/IGF1 secretion in patients with acromegaly is protective for periodontal health. Diabetes is prevalent comorbidity in patients of acromegaly and is associated with worsening of periodontal disease. The present study evaluates the periodontal health and cytokines status in treatment-naive active acromegaly patients with and without diabetes. Eleven patients, each of acromegaly with and without diabetes and 20 healthy controls were enrolled. Periodontal parameters were assessed. GCF and blood samples for IL-6, TGF-β1, and PDGF were obtained. Serum GH, IGF1, HbA1c, pituitary hormones and MRI sella were performed in patients with acromegaly. There was no significant difference in periodontal status of patients with acromegaly and healthy controls. However, a significant increase in serum IL-6 (p = 0.019) and TGF-β1 (p = 0.025) levels in patients with acromegaly was observed and all patients had concurrent hypogonadism. Nevertheless, the patients with acromegaly having diabetes had modestly higher CAL and PD and serum IL-6 levels (p = 0.051), but it could not exert adverse effects on periodontal health in presence of GH/IGF1 excess. GH/IGF1 excess did not exert a protective effect on periodontal status in acromegaly, possibly due to concurrent hypogonadism and opposing cytokines; however, it could mask the ill-effects of diabetes on periodontal health.

Highlights

Associated with it like diabetes and hypogonadism have an impact on cytokine profile; thereby may influence periodontal outcome
The study groups comprised of Group A: acromegaly patients with diabetes; Group B: acromegaly patients with normal glucose tolerance and Group C: Twenty age and sex-matched systemically healthy adults recruited from the Department of Oral Diagnosis
The mean age of the patients of active acromegaly with and without diabetes was comparable with controls

Summary

Introduction

Associated with it like diabetes and hypogonadism have an impact on cytokine profile; thereby may influence periodontal outcome. A few studies have explored the effect of GH/IGF1 hypersecretion on periodontal status in patients with acromegaly[7,8,9,10,21]. No study has assessed their effect on periodontal status in these patients with concomitant diabetes, as diabetes is a highly prevalent coexisting comorbidity and might counteract the beneficial effect of these anabolic hormones on periodontal disease in these patients. Our study was planned to assess the prevalence of chronic periodontitis and levels of various anti- and pro-inflammatory cytokines in patients of acromegaly with or without diabetes

Methods

Results

Conclusion